Related Experiment Video
Updated: Jun 18, 2026
08:24
Isolation and Identification of Extravascular Immune Cells of the Heart
Published on: August 23, 2018
Immune Profiling Identifies Inflammatory Signatures in Immune Checkpoint Inhibitor-Related Myocarditis
Douglas Daoudlarian1, Sarah Boughdad2, Robin Bartolini1
1Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne, Department of Medicine, Immunology and Allergy Service, Lausanne, Switzerland.
JACC. Cardiooncology
|June 17, 2026
Summary
Immune checkpoint inhibitor-associated myocarditis (ICI-My) shows a distinct inflammatory signature centered on IL-6 and chemokines. Conventional cardiac biomarkers are better for assessing ICI-My severity than single cytokines.
Area of Science:
- Immunology
- Cardiology
- Oncology
Background:
- Immune checkpoint inhibitor-associated myocarditis (ICI-My) is a rare but serious adverse event.
- There is a need for biomarkers to differentiate ICI-My from general immune activation by immune checkpoint inhibitors (ICIs).
Purpose of the Study:
- To characterize the circulating inflammatory and cellular immune profiles in ICI-My.
- To correlate these immune profiles with clinical severity.
- To explore the potential of interleukin-6 receptor (IL-6R) blockade in refractory cases.
Main Methods:
- Retrospective cohort study of 33 ICI-My patients and 68 ICI-treated controls.
- Multiplex cytokine profiling and mass cytometry analyses were performed.
- Eight steroid-refractory ICI-My patients were treated with tocilizumab compassionately.
Main Results:
- ICI-My patients exhibited elevated circulating IL-6, chemokines (CCL3, CCL4, CCL5, CXCL9, CXCL10, CXCL13), and VEGF-A compared to controls.
- Distinct cellular immune differences were observed, including altered neutrophil and T/B cell populations.
- Conventional cardiac biomarkers (troponin T, BNP, AST, ALT) were more effective in distinguishing severe from non-severe ICI-My.
Conclusions:
- Peripheral immune profiling reveals an IL-6 and chemokine-driven inflammatory signature specific to ICI-My.
- Standard cardiac biomarkers are more reliable for assessing ICI-My severity.
- IL-6R blockade with tocilizumab is feasible in selected steroid-refractory cases and warrants further investigation.
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