T-cell–derived and –activating cytokines in calcified aortic valve cusps. Relative gene expression (normalized to noncalcified areas of stenotic valves) of Perforin 1 (A), Granzyme B (C), heat shock protein (Hsp)60 (E), CXCL9 (G), and major histocompatibility complex class II transactivator (CIITA; I). Immunohistochemical localization of Perforin 1 (B), Granzyme B (D), Hsp60 (F), CXCL9 (H), and human leukocyte antigen (HLA)-DR (J). All sections were counterstained with hematoxylin for visualization of the nuclei. n = 116 cusp portions (A, C, E, G, and I); n = 5 (B, D, F, H, and J). ∗P < 0.05, ∗∗P < 0.01. Scale bars = 100 μm. GAPDH, glyceraldehyde-3-phosphate dehydrogenase. DR, antigen-D related.