Expression of proliferating cell markers in normal and diseased human hearts

Eloisa Arbustini, Marta Diegqli, Maurizia Grasso, Roberta Fasani, Andrea D'Armini, Luigi Martinelli, Claudio Goggi, Carlo Campana, Antonello Gavazzi, Mario Vigano'

Research output: Contribution to journalArticlepeer-review


Proliferating cell nuclear antigen (PCNA) myocyte expression and histopathologic features related to its occurrence were investigated in normal and diseased hearts of adult humans using both immunohistochemical and Western blotting techniques. Ki67 Western blotting was also performed in the same samples used for PCNA blotting. Two hundred seventy-one endomyocardial biopsies, and 15 adult, 1 embryonic and 2 fetal hearts were studied. The biopsies were from normal donor hearts (n = 71), patients with cardiomyopathy and myocarditis (n = 64), and patients with transplantation with (n = 106) and without (n = 30) acute rejection of any grade. The 15 hearts were from 1 heart donor, and from patients with cardiomyopathy (n = 5), valvular heart disease (n = 2), ischemic heart disease (n = 4), amyloidosis (n = 1) and transplantation with acute rejection (n = 2). The PCNA labeling index was plotted against myocyte hypertrophy, inflammatory infiltrates and binucleation index. The PCNA labeling index ranged from 2 to 9% in embryonic and fetal hearts. PCNA was expressed by 1 to 2% of myocyte nuclei in 12% of normal heart biopsies, 1 to 5% of myocyte nuclei in 28% of cardiomyopathy and myocarditis biopsies, and by up to 8% of myocyte nuclei in 53% of biopsies of patients with transplantation, independently of the presence and degree of acute rejection. In the latter biopsies and in myocarditis, some inflammatory cells also showed PCNA expression. PCNA positive myocytes were both mono- and binucleated, and there was no correlation between binucleation and PCNA labeling indexes. Ki67 and PCNA blotting confirmed imiminohistochemical results. The results show that few myocytes express PCNA in normal hearts. This expression is only detectable by immunohistochemical stains. The percentage of PCNA expressing myocytes increases in diseased hearts of any origin, so that it becomes detectable by both immunohistochemical and Western blotting techniques. Data from transplanted heart biopsies confirm that as in myocarditis, immunologic-inflammatory stimuli are likely powerful triggers of PCNA expression. Therefore, cardiac myocytes of adult humans can express proliferating cell markers, and this expression increases in hearts with hypertrophy or inflammatory reaction.

Original languageEnglish
Pages (from-to)608-614
Number of pages7
JournalThe American Journal of Cardiology
Issue number7
Publication statusPublished - Sep 1 1993

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


Dive into the research topics of 'Expression of proliferating cell markers in normal and diseased human hearts'. Together they form a unique fingerprint.

Cite this