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Analysis of Cytokine Profiles in Pediatric Myocarditis Multicenter Study
Yoji Nomura1, Takanori Suzuki2,3, Katsuyuki Kunida4
1Department of Pediatric Cardiology, Aichi Children's Health and Medical Center, Aichi, Japan.
Insights
Cytokine profiles can distinguish severe pediatric fulminant myocarditis (FM) from acute myocarditis (AM). Specific cytokine levels may help predict disease severity and guide targeted therapies for myocarditis in children.
Area of Science:
- Pediatric Cardiology
- Immunology
- Molecular Biology
Background:
- Acute myocarditis (AM) is an inflammatory heart condition that can progress to severe, life-threatening fulminant myocarditis (FM).
- Understanding the cytokine profiles in pediatric myocarditis, particularly in relation to FM, is crucial for diagnosis and treatment.
- Current knowledge on cytokine differences between pediatric AM and FM is limited.
Purpose of the Study:
- To evaluate and compare the cytokine profiles of pediatric patients with acute myocarditis (AM) and fulminant myocarditis (FM).
- To identify specific cytokines that can differentiate between AM and FM in children.
- To explore the potential of cytokine profiles for disease stratification and prognosis prediction.
Main Methods:
- A cohort of pediatric patients diagnosed with AM or FM was studied.
- Cytokine levels were quantified using a multiplexed fluorescent bead-based immunoassay.
- Statistical analyses, including Principal Component Analysis (PCA), were employed to compare cytokine levels between FM, AM, and healthy control (HC) groups.
Main Results:
- Four cytokines (IL-1RA, IL-8, IL-10, IL-15) were significantly elevated in the FM group compared to the AM group.
- Interleukin-4 (IL-4) was significantly higher in the AM group than in both FM and HC groups.
- Platelet-Derived Growth Factor-AA (PDGF-AA) and Vascular Endothelial Growth Factor-A (VEGF-A) were significantly lower in the FM group than in the AM group.
Conclusions:
- Distinct cytokine profiles exist between pediatric fulminant myocarditis (FM) and acute myocarditis (AM).
- Cytokine analysis may serve as a valuable tool for differentiating FM from AM, assessing disease severity, and predicting patient outcomes.
- Targeted therapies focusing on individual cytokines hold potential for managing myocarditis and preventing progression to FM, warranting further investigation.
Abstract:
Acute myocarditis (AM) is an inflammatory disease of the heart muscle that can progress to fulminant myocarditis (FM), a severe and life-threatening condition. The cytokine profile of myocarditis in children, especially in relation to fulminant myocarditis, is not well understood. This study aims to evaluate the cytokine profiles of acute and fulminant myocarditis in children. Pediatric patients diagnosed with myocarditis were included in the study. Cytokine levels were measured using a multiplexed fluorescent bead-based immunoassay. Statistical analysis was performed to compare patient characteristics and cytokine levels between FM, AM, and healthy control (HC) groups. Principal component analysis (PCA) was applied to cytokine groups that were independent among the FM, AM, and HC groups. The study included 22 patients with FM and 14 with AM patients. We identified four cytokines that were significantly higher in the FM group compared to the AM group: IL1-RA (p = 0.002), IL-8 (p = 0.005), IL-10 (p = 0.011), and IL-15 (p = 0.005). IL-4 was significantly higher in the AM group compared to FM and HC groups (p = 0.006 and 0.0015). PDGF-AA, and VEGF-A were significantly lower in the FM group than in the AM group (p = 0.013 and <0.001). Similar results were obtained in PCA. Cytokine profiles might be used to differentiate pediatric FM from AM, stratify severity, and predict prognosis. The targeted therapy that works individual cytokines might provide a potential treatment for reducing the onset of the FM and calming the condition, and further studies are needed.
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