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Molecular pathogenesis of enterovirus-induced myocarditis: virus persistence and chronic inflammation
Abstract:
In situ hybridization studies have proved that myocardial enterovirus infections are detectable in all stages of acute and chronic enterovirus-induced myocarditis as well as in some patients with end-stage dilated cardiomyopathy, suggesting the possibility of myocardial enterovirus persistence. Possible enterovirus persistence in the human heart is supported by the discovery of enterovirus persistence in different murine models of chronic myocarditis, demonstrating that coxsackievirus B3, typically a cytolytic enterovirus, is capable of evading immunological surveillance in a host-dependent fashion. Progress is currently being made in unraveling the molecular mechanisms of enterovirus persistence, the diversity of host and virus genetics and their impact on the nature and severity of the disease. Apart from providing an etiologic diagnosis, there are therapeutic implications from the in situ demonstration of myocardial enterovirus infection. Evaluation of specific antiviral agents, for example interferons, may lead to the development of new therapeutic strategies capable of providing protection against myocardial enterovirus infection.
Insights
Myocardial enterovirus infections, often linked to myocarditis and dilated cardiomyopathy, may persist in the heart. Research is exploring viral persistence mechanisms and potential antiviral therapies.
Area of Science:
- Cardiology
- Virology
- Immunology
Background:
- Myocardial enterovirus infections are detected in various stages of myocarditis and dilated cardiomyopathy.
- Evidence suggests enteroviruses can persist in the human heart, supported by murine models.
Purpose of the Study:
- To investigate the possibility of enterovirus persistence in the human myocardium.
- To understand the molecular mechanisms and host-virus genetic factors influencing enterovirus persistence.
- To explore therapeutic implications of detecting myocardial enterovirus infections.
Main Methods:
- In situ hybridization studies to detect enterovirus infections in myocardial tissue.
- Utilizing murine models of chronic myocarditis to study enterovirus persistence.
- Investigating host and virus genetics impacting disease severity.
Main Results:
- Enteroviruses are detectable in acute and chronic myocarditis, and some dilated cardiomyopathy cases.
- Coxsackievirus B3 demonstrates evasion of immunological surveillance in a host-dependent manner.
- Progress is being made in understanding molecular mechanisms of enterovirus persistence.
Conclusions:
- Myocardial enterovirus persistence is a plausible phenomenon in heart disease.
- Understanding persistence mechanisms can guide the development of new diagnostic and therapeutic strategies.
- Antiviral agents like interferons show potential for protecting against myocardial enterovirus infections.