Figure 2: The regulatory cytokine IL-4 is misrepresented in the valves. Mononuclear cells producing IL-10 and IL-4 were evaluated by immunohistochemistry in myocardium and valvular tissue of RHD patients (n=11) [30]. Most of samples from the myocardium tissue (82%) had IL-4 positive cells, while 78% of valvular samples have low numbers of IL- 4 positive cells.