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[Patterns of acute and persistent infections in enteroviral heart diseases]
G Mall1, K Klingel, M Albrecht
1Pathologisches Institut, Universität Heidelberg.
Abstract:
Enteroviruses are considered as the major etiologic agents of myocarditis in humans. Recent in situ hybridization studies on endomyocardial biopsies indicate that not only in acute myocarditis (pattern of acute infection), but also in chronic dilated cardiomyopathy enterovirus RNA can be detected (pattern of persistent infection). Our experimental studies on murine coxsackievirus B3 myocarditis provided evidence that persistent infection occurs also in mice. Quantitative in-situ hybridization and immunohistochemistry as well as electron microscopic in situ hybridization experiments were performed on ACA/SnJ mice three to thirty days after infection. The pattern of acute infection (days 3-9 p.i.) is characterized by rapid progression of myocardial lesions, an increasing number of inflammatory cells and a high number of infected myocytes. Hallmarks of the persistent pattern (day 15-30 p.i.) are reduced inflammation, reduced numbers of persistently infected cells and a slow progression of myocardial lesions. Infection is primarily restricted to degenerated, atrophic myocytes and to fibroblasts.
Insights
Enteroviruses cause myocarditis. Persistent enterovirus infection, characterized by reduced inflammation and slow lesion progression, occurs in mice, mirroring human chronic dilated cardiomyopathy.
Area of Science:
- Virology
- Cardiology
- Pathology
Context:
- Enteroviruses are primary causes of human myocarditis.
- Enterovirus RNA is detected in both acute myocarditis and chronic dilated cardiomyopathy.
- Persistent enterovirus infection is a recognized pattern in human cardiac disease.
Purpose:
- To investigate the occurrence and characteristics of persistent enterovirus infection in a murine model.
- To compare acute and persistent infection patterns in coxsackievirus B3-induced myocarditis.
- To elucidate the cellular localization and progression of viral infection in the myocardium over time.
Summary:
- Experimental studies on ACA/SnJ mice infected with coxsackievirus B3 revealed distinct patterns of acute and persistent infection.
- Acute infection (days 3-9 post-infection) showed rapid myocardial lesions, inflammation, and high myocyte infection rates.
- Persistent infection (days 15-30 post-infection) was characterized by reduced inflammation, fewer infected cells, and slow lesion progression, primarily in degenerated myocytes and fibroblasts.
Impact:
- Provides experimental evidence for persistent enterovirus infection in a mouse model, relevant to human myocarditis and dilated cardiomyopathy.
- Highlights the distinct pathological features differentiating acute from persistent viral cardiac infections.
- Offers insights into the long-term viral dynamics and cellular tropism in viral cardiomyopathy.