Cardiac autoimmunity: Myocarditis

William Bracamonte-Baran, Daniela Čiháková

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Myocarditis is the inflammation of the muscle tissues of the heart (myocardium). After a pathologic cardiac-specific inflammatory process, it may progress to chronic damage and dilated cardiomyopathy. The latter is characterized by systolic dysfunction, whose clinical correlate is heart failure. Nevertheless, other acute complications may arise as consequence of tissue damage and electrophysiologic disturbances. Different etiologies are involved in triggering myocarditis. In some cases, such as giant cell myocarditis or eosinophilic necrotizing myocarditis, it is an autoimmune process. Several factors predispose the development of autoimmune myocarditis such as systemic/local primary autoimmunity, viral infection, HLA and gender bias, exposure of cryptic antigens, mimicry, and deficient thymic training/Treg induction. Once the anti-myocardium autoimmune process is triggered, several components of the immune response orchestrate a sustained attack toward myocardial tissues with particular timing and immunopathogenic features. Innate response mediated by monocytes/macrophages, neutrophils, and eosinophils parallels the adaptive response, playing a final effector role and not only a priming function. Stromal cells like fibroblast are also involved in the process through specific cytokines. Furthermore, adaptive T cell responses have anti-paradigmatic features, as Th17 response is dispensable for acute myocarditis but is the main driver of the process leading to dilated cardiomyopathy. Humoral response, thought to be a bystander, is important in the appearance of late-stage hemodynamic complications. The complexity of that process, as well as the unspecific and variable clinical presentation, had generated difficulties for diagnosis and treatment, which remain suboptimal. In this chapter, we will discuss the most relevant immunopathogenic findings from a basic science and clinical perspective.

Original languageEnglish (US)
Title of host publicationAdvances in Experimental Medicine and Biology
PublisherSpringer New York LLC
Pages187-221
Number of pages35
Volume1003
DOIs
StatePublished - 2017

Publication series

NameAdvances in Experimental Medicine and Biology
Volume1003
ISSN (Print)0065-2598
ISSN (Electronic)2214-8019

Fingerprint

Myocarditis
Autoimmunity
Library Catalogs
Myocardium
Dilated Cardiomyopathy
Aldehyde Oxidoreductases
T-cells
Macrophages
Hemodynamics
Fibroblasts
Molecular Mimicry
Sexism
Giant Cells
Stromal Cells
Eosinophils
Monocytes
Neutrophils
Heart Failure
Cytokines
Inflammation

Keywords

  • Adaptive response
  • Autoimmunity
  • Dilated cardiomyopathy
  • Myocarditis

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

Bracamonte-Baran, W., & Čiháková, D. (2017). Cardiac autoimmunity: Myocarditis. In Advances in Experimental Medicine and Biology (Vol. 1003, pp. 187-221). (Advances in Experimental Medicine and Biology; Vol. 1003). Springer New York LLC. DOI: 10.1007/978-3-319-57613-8_10

Cardiac autoimmunity : Myocarditis. / Bracamonte-Baran, William; Čiháková, Daniela.

Advances in Experimental Medicine and Biology. Vol. 1003 Springer New York LLC, 2017. p. 187-221 (Advances in Experimental Medicine and Biology; Vol. 1003).

Research output: Chapter in Book/Report/Conference proceedingChapter

Bracamonte-Baran, W & Čiháková, D 2017, Cardiac autoimmunity: Myocarditis. in Advances in Experimental Medicine and Biology. vol. 1003, Advances in Experimental Medicine and Biology, vol. 1003, Springer New York LLC, pp. 187-221. DOI: 10.1007/978-3-319-57613-8_10
Bracamonte-Baran W, Čiháková D. Cardiac autoimmunity: Myocarditis. In Advances in Experimental Medicine and Biology. Vol. 1003. Springer New York LLC. 2017. p. 187-221. (Advances in Experimental Medicine and Biology). Available from, DOI: 10.1007/978-3-319-57613-8_10

Bracamonte-Baran, William; Čiháková, Daniela / Cardiac autoimmunity : Myocarditis.

Advances in Experimental Medicine and Biology. Vol. 1003 Springer New York LLC, 2017. p. 187-221 (Advances in Experimental Medicine and Biology; Vol. 1003).

Research output: Chapter in Book/Report/Conference proceedingChapter

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