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Formation of the inflammasome in acute myocarditis

2014; Elsevier BV; Volume: 171; Issue: 3 Linguagem: Inglês

10.1016/j.ijcard.2013.12.137

1874-1754

Stefano Toldo, Harsha Kannan, Rossana Bussani, Marco Anzini, Chiara Sonnino, Gianfranco Sinagra, Marco Merlo, Eleonora Mezzaroma, Fabio De‐Giorgio, Furio Silvestri, Benjamín W. Van Tassell, Alfonso Baldi, Antonio Abbate,

Cardiovascular Effects of Exercise

Acute myocarditis is an inflammatory disorder of the heart muscle in which the severity of injury depends both on the nature of the offending agent (i.e. virus) and on the ensuing inflammatory response. The definition excludes, however, the response to ischemic or toxic injury. The heart, however, like other organs, may provide a stereotyped response to injury. Following ischemic injury, the formation of the inflammasome in the heart promotes heart failure [ [1] Mezzaroma E. Toldo S. Farkas D. et al. The inflammasome promotes adverse cardiac remodeling following acute myocardial infarction in the mouse. Proc Natl Acad Sci U S A. 2011; 108: 19725-19730 Crossref PubMed Scopus (401) Google Scholar ]. The inflammasome is a macromolecular structure activated during injury that amplifies the response by processing Interleukin-1β (IL-1β) and IL-18, and promotion of cell death [ [2] Strowig T. Henao-Mejia J. Elinav E. Flavell R. Inflammasomes in health and disease. Nature. 2012; 481: 278-286 Crossref PubMed Scopus (1566) Google Scholar ]. Viral infections may lead to either death of the virus and the cell (pyroptosis), or survival of both cell and virus with persistence of the infection through inhibition of the inflammasome (evasion) [ [3] Gram A.M. Frenkel J. Ressing M.E. Inflammasomes and viruses: cellular defense versus viral offence. J Gen Virol. 2012; 93: 2063-2075 Crossref PubMed Scopus (53) Google Scholar ]. There are no reports of the inflammasome in acute myocarditis. We hypothesize that the viral infection or the ensuing cellular destruction leads to the formation of the inflammasome, providing an opportunity to explore inflammasome-related markers for diagnostic or prognostic purposes. Furthermore at present day, there are no specific treatments for acute myocarditis, and thus inhibitors of the inflammasome could represent a new therapeutic approach.