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Treatment of experimental myocarditis via modulation of the renin-angiotensin system

Melvin D Daniels1, Kenneth V Hyland, David M Engman

  • 1Department of Pathology and Microbiology-Immunology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA. d-engman@northwestern.edu

Current Pharmaceutical Design
|May 18, 2007
PubMed

Insights

Drugs targeting the renin-angiotensin system, like ACE inhibitors and ARBs, show promise for treating myocarditis. They reduce inflammation and fibrosis without broad immune suppression, aiding recovery from heart inflammation.

Area of Science:

  • Cardiovascular Research
  • Immunology
  • Pharmacology

Background:

  • The renin-angiotensin system regulates vascular tone and is targeted by drugs for hypertension and cardiomyopathy.
  • Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor antagonists (ARBs) also impact inflammation, adhesion molecules, and fibrosis.
  • Myocarditis, an inflammatory heart condition, presents a potential therapeutic target for these agents.

Purpose of the Study:

  • To review the efficacy of ACEIs and ARBs in experimental models of infectious and autoimmune myocarditis.
  • To assess the therapeutic potential of renin-angiotensin system modulation for inflammatory heart disease.

Main Methods:

  • Review of studies using mouse models of virus-induced myocarditis.
  • Review of studies using mouse models of parasite-induced myocarditis.
  • Review of studies using mouse models of autoimmune cardiomyopathy.

Main Results:

  • ACEIs and ARBs demonstrate efficacy in treating various forms of experimental myocarditis.
  • These drugs modulate key inflammatory and fibrotic pathways in the heart.
  • Renin-angiotensin modulation appears to downregulate autoimmunity without causing detrimental immune suppression.

Conclusions:

  • Evidence strongly supports using renin-angiotensin modulation for myocarditis treatment.
  • This approach offers a potential strategy for managing inflammatory heart diseases.
  • Therapeutic benefits include reduced inflammation and fibrosis with preserved immune function.

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