The Levels Of Serum Granzyme B And SFasL Are Involved In The Development Of Virus Myocarditis In Children

Objective The cell-mediated cytotoxicity by Cytotoxic T lymphocyte (CTL) is the main mechanism of myocardium injury. It has been known that perforin /Granzyme B (GrB)-based mechanisms account for all T cell-mediated cytotoxicity. However the molecular pathways of CTL are still elusive. To evaluate the changes of Granzyme B (GrB) and soluble Fas Ligand (sFasL) by measuring the level of GrB and sFasL from peripheral blood of patients with viral myocarditis and the relationship between these changes of GrB, sFasL and cardiac enzymes, cardiac troponin I (cTnI), electrocardiogram(ECG), echocardiogram(ECHO) and heart function. To study whether and to what extend GrB and sFasL involved in the development of virus myocarditis.Methods The peripheral bloods from 60 children with viral myocarditis and 40 normal children were taken. The levels of GrB and sFasL were measured by enzyme-linked immunosorbent assay (ELISA). Cardiac enzymes, cTnI, ECG, ECHO and heart function of 60 children with viral myocarditis were also measured.Results (1) The levels of GrB [ (26.20 ± 5.02) pg/ml] and sFasL[ (42.10±10.01) pg/ ml] were higher than the levels of GrB[ ( 12.05±2.31 ) pg/ ml] andsFasL[ (22.40±7.05 ) pg/ ml] in childreh with viral myocarditis (P of both <0.01). (2) The percentage of children with abnormal cardiac enzymes whose GrB and sFasL were elevated was increased (P of all <0.05). (3) The percentage of cTnl abnormality from the patients whose GrB and sFasL were elevated was increased (P of both <0.05). (4) The percentage of abnormal ECG of the patients whose GrB and sFasL were elevated was increased (P of both < 0.05). (5) The percentage of abnormal ECHO of patients whose GrB and sFasL were elevated was increased (P of both < 0.05). (6) There was no correlation between GrB and sFasL level with heart function.Conclusion The levels of GrB and sFasL were higher in children with viral myocarditis than in normal children. There were positive correlations between the level of GrB or sFasL and the abnormalities in cardiac enzymes, cTnl, ECG and ECHO. CTL is involved in the development of viral myocarditis by perforin/GrB and Fas/FasL pathway.