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By Dr. T. Powell (auth.), H. M. Piper, P. G. Spieckermann (eds.)

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Characteristic differences between myolemma , sarcolemma and endothelium could be defined. - [n patients with perimyocarditis and postmyocarditic cardiomyopathy antibodies directed against the myolemma were detected. They are cytolytic in the presence of complement and cross-reactive to the causative viral agents. Furthermore lymphocytotoxic effector mechanisms could be demonstrated in vilro in one third of patients with AM LA-negative primary dilated cardiomyopathy. Key wards: antimyolemmal antibodies, antisarcolemmal antibodies, cytotoxicity, cardiomyopathy, viral myocarditis Introduction The sarcolemma, like any other membrane, is composed of the structural pospholipid bilayer, the lipophilic cholesterol moieties to increase viscoelasticity, the unipolar or bipolar membrane proteins as structural elements, receptors, transport molecules and epitopes relevant for immunologic interactions, and glycoproteins, which are responsible for the unique tissue-specific and species-specific properties.

2 fold stimulation of lactate production and stimulates CO 2 formation by 56 ± 5%. This again increases the lactate/C0 2 ratio up to 7 fold (Fig. I). Half maximal effective dose of insulin is 10- 9 M which agrees with data reported for the stimulation of the glucose transporter (4). Thus we can assume that the increased glycolytic flux is caused by insulin-stimulated glucose entry into the cell and presumably by subsequent activation of phosphofructokinase (7) . However, the increase in glycolytic flux preferentially leads to enhanced lactate formation, as this seems to be the main route by which cytosolic NADH can be reoxidized.

4 .. " of myocarditis (n. 10) Coxsackie B .. 15) •. ) G Mumpsorchitis ( n. 4 ) Cytomegalovorus (n. 20) healthy normals (n. 70) 8. • o • • j" no AMLA noAMLA t :l0 1: 20 1:40 1:80 1:160 1-320 AMLA - titre Fig. I. Cytolytic serum activity in viral perimyocarditis correlated with the titer or antimyolcmmal antibodies. Table 2. 13 incidence or blocking ractors present***) (%) 8 22 9 *) cardiocyte index or lymphocytotoxicity **) cardiocyte index or Iymphocytotoxicity blocking ractors ***) . d 075' C[ = haIr lire or cardiocytes in presence or pat.

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