Myocarditis in auto-immune or auto-inflammatory diseases

Abstract

Myocarditis is a major cause of heart disease in young patients and a common precursor of heart failure due to dilated cardiomyopathy. Some auto-immune and/or auto-inflammatory diseases may be accompanied by myocarditis, such as sarcoidosis, Behçet's disease, eosinophilic granulomatosis with polyangiitis, myositis, and systemic lupus erythematosus. However, data concerning myocarditis in such auto-immune and/or auto-inflammatory diseases are sparse. New therapeutic strategies should better target the modulation of the immune system, depending on the phase of the disease and the type of underlying auto-immune and/or auto-inflammatory disease.

Myocarditis: An Interleukin-1-Mediated Disease?

“…As most of immune-mediated diseases, VNM is considered a multifactorial entity, with several immunologic mechanisms contributing to disease development and progression. Environmental triggers of myocardium damage lead to local inflammation and exposure of cryptic self-antigens: excessive innate and myocardium-specific immune responses ensue in genetically predisposed individuals ( 16 , 31 – 35 ) and result in a self-sustained autoimmune or inflammatory cycle independent of the original triggering agent.…”

“…When no infectious agents are identified on EMB and other known causes are excluded, autoimmune myocarditis (AMy) is the presumed etiology ( 15 ). These so-called “autoimmune myocarditis” or “virus-negative myocarditis” may occur as a distinct disease with exclusive cardiac involvement, or in the context of systemic autoimmune or inflammatory disorders with extracardiac involvement ( 5 , 16 – 23 ).…”

Involvement of miR-126 in autoimmune disorders

“…Cardiomyopathies are a group of diseases influenced by the intervention of immune system cells leading to an impaired function of the myocardium. miRNAs were found being abundant in biological fluids, especially in various pathological conditions such as in cardiovascular disease [ 53 – 55 ].…”

Transient left bundle branch block and left ventricular dysfunction in a patient with NLRP1-associated autoinflammation with arthritis and dyskeratosis syndrome

“…Cardiac involvement in autoimmune or autoinflammatory disorders can manifest as pericarditis, myocarditis, endocarditis, and coronary artery disease. 3 The NLRP1-associated autoinflammation with arthritis and dyskeratosis syndrome is a rare autoinflammatory disorder, characterised by diffuse skin dyskeratosis, arthritis, and recurrent fever. This girl has a de novo heterozygous mutation (c.3641C > G, p.Pro1214Arg) in the NLRP1 gene (1).…”