[Relation between the clinical course of acute myocardial infarction and specific sensitization of lymphocytes and lymphotoxin production]

Seventy-eight patients with acute myocardial infarction (MI) were examined in order to assess the place of immune response caused by myocardial necrosis in the clinical pattern of the disease. The extent of autosensitization was estimated on the basis of E-RFC inhibition and lymphotoxin production in lymphocyte cultures in the presence of myocardial antigen. Sensitized lymphocytes emerge in the blood during the second week in primary acute MI, and during the first day in repeated acute MI. Patients with marked autosensitization more frequently developed recurrent anginal attacks and cardiovascular insufficiency; they were the only ones to show Dressler's syndrome and fatal outcomes. A positive correlation between cell sensitization and elevated IgG was seen during the third week of the disease. Lymphotoxin production tended to be increased in patients with repeated acute MI and Dressler's syndrome.