Th1/Th2 balance alteration in the clinical course of a patient with acute viral myocarditis

Cytokines have an important role in the pathogenesis and pathophysiology of myocarditis. In this study, subsets of peripheral helper T lymphocytes (Th ) in a patient with acute viral myocarditis were analyzed by 3-color flow c ytometry. During the clinical course of myocarditis. the Th1/Th2 ratio of p eripheral lymphocytes changed. Th1 was dominant in the acute inflammatory p hase during which levels of creatine kinase (CK) increased (day 6), then Th 2 levels overtook those of Th1 in the recovery phase during which levels of CK decreased (day 13 and 20). At the time of discharge (day 35), Th1 and T h2 had normalized. Thus, it was speculated that the induction of lymphocyti c myocarditis was associated with Th1 dominant status, and recovery was rel ated to Th2 polarity. Th subset imbalances may play an important role in th e pathogenesis of acute viral myocarditis and these analyses may be useful for understanding the disease activity of myocarditis.