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University of Illinois Urbana-Champaign

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Circ. Res., Jun 07 2024, 134 (12) | https://doi.org/10.1161/CIRCRESAHA.124.323816 Autoimmune Myocarditis, Old Dogs and New Tricks

Taejoon Won, Evelyn J. Song, Hannah M. Kalinoski, Javid J. Moslehi^*, and Daniela Čiháková^*

Department of Pathobiology, College of Veterinary Medicine, University of Illinois Urbana-Champaign (T.W.). Section of Cardio-Oncology and Immunology, Division of Cardiology and the Cardiovascular Research Institute, University of California San Francisco (E.J.S., J.J.M.). W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (H.M.K., D.Č). Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD (D.Č).

^*J.J. Moslehi and D. Čiháková contributed equally.

Correspondence to: Daniela Čiháková, MD, PhD or Javid J. Moslehi, MD

Abstract

Autoimmunity significantly contributes to the pathogenesis of myocarditis, underscored by its increased frequency in autoimmune diseases such as systemic lupus erythematosus and polymyositis. Even in cases of myocarditis caused by viral infections, dysregulated immune responses contribute to pathogenesis. However, whether triggered by existing autoimmune conditions or viral infections, the precise antigens and immunologic pathways driving myocarditis remain incompletely understood. The emergence of myocarditis associated with immune checkpoint inhibitor therapy, commonly used for treating cancer, has afforded an opportunity to understand autoimmune mechanisms in myocarditis, with autoreactive T cells specific for cardiac myosin playing a pivotal role. Despite their self-antigen recognition, cardiac myosin-specific T cells can be present in healthy individuals due to bypassing the thymic selection stage. In recent studies, novel modalities in suppressing the activity of pathogenic T cells including cardiac myosin-specific T cells have proven effective in treating autoimmune myocarditis. This review offers an overview of the current understanding of heart antigens, autoantibodies, and immune cells as the autoimmune mechanisms underlying various forms of myocarditis, along with the latest updates on clinical management and prospects for future research.

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형식Review Paper
게재일2024년 06월 (BRIC 등록일 2024-06-10)
연구진국외 연구진
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