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Bassetto G, Merlo M, Dal Ferro M, Setti M, Paldino A, Collesi C, Artioli R, Loffredo F, D'Elia S, Golino P, Fabris E, Bussani R, Metra M, Limongelli G, Sinagra G. Apoptosis, a useful marker in the management of hot-phase cardiomyopathy? Eur J Heart Fail 2024; 26:590-597. [PMID: 38414301 DOI: 10.1002/ejhf.3173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 02/02/2024] [Accepted: 02/11/2024] [Indexed: 02/29/2024] Open
Abstract
AIMS 'Hot phases', characterized by chest pain and troponin release, may represent the first clinical presentation of arrhythmogenic cardiomyopathies. Differential diagnosis with acute myocarditis is an unmet challenge for the clinicians. We sought to investigate histological and genetic features in patients with cardiomyopathy presenting with hot phases. METHODS AND RESULTS We evaluated a case series of consecutive patients hospitalized for suspected 'hot-phase cardiomyopathy' in two Italian centres from June 2017 to March 2022 (median follow-up 18 months) that underwent both endomyocardial biopsy (EMB) and genetic testing. Apoptosis was confirmed with TUNEL assay. Among the 17 enrolled patients (mean age 34 ± 15 years, 76% male), only six patients (35%) presented standard histological and immunohistochemical markers for significant cardiac inflammation at EMB. Conversely, apoptosis was found in 13 patients (77%). Genetic testing was positive for a pathogenic/likely pathogenic (P/LP) variant in genes involved in cardiomyopathies (most frequently in DSP) in eight patients (48%), rising to 62% among patients with apoptosis on EMB. Notably, all patients without apoptosis tested negative for P/LP disease-related variants. Left ventricular ejection fraction was lower in patients showing apoptosis at EMB compared to those without (p = 0.003). CONCLUSIONS Apoptosis, rather than significant inflammation, was mostly prevalent in this case series of patients with 'hot-phase' presentation, especially in carriers of variants in cardiomyopathy-related genes. Detecting apoptosis on EMB might guide clinicians in performing genetic testing and in more tailored therapeutic choices in 'hot-phase cardiomyopathy'.
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Affiliation(s)
- Giulia Bassetto
- Cardiovascular Department, Center for Diagnosis and Treatment of Cardiomyopathies, Azienda Sanitaria Universitaria Giuliano-Isontina, University of Trieste, Trieste, Italy
- European Reference Network for Rare, Low-Prevalence, and Complex Diseases of the Heart (ERN GUARD-Heart)
| | - Marco Merlo
- Cardiovascular Department, Center for Diagnosis and Treatment of Cardiomyopathies, Azienda Sanitaria Universitaria Giuliano-Isontina, University of Trieste, Trieste, Italy
- European Reference Network for Rare, Low-Prevalence, and Complex Diseases of the Heart (ERN GUARD-Heart)
| | - Matteo Dal Ferro
- Cardiovascular Department, Center for Diagnosis and Treatment of Cardiomyopathies, Azienda Sanitaria Universitaria Giuliano-Isontina, University of Trieste, Trieste, Italy
- European Reference Network for Rare, Low-Prevalence, and Complex Diseases of the Heart (ERN GUARD-Heart)
| | - Martina Setti
- Cardiovascular Department, Center for Diagnosis and Treatment of Cardiomyopathies, Azienda Sanitaria Universitaria Giuliano-Isontina, University of Trieste, Trieste, Italy
- European Reference Network for Rare, Low-Prevalence, and Complex Diseases of the Heart (ERN GUARD-Heart)
- Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy
| | - Alessia Paldino
- Cardiovascular Department, Center for Diagnosis and Treatment of Cardiomyopathies, Azienda Sanitaria Universitaria Giuliano-Isontina, University of Trieste, Trieste, Italy
- European Reference Network for Rare, Low-Prevalence, and Complex Diseases of the Heart (ERN GUARD-Heart)
| | - Chiara Collesi
- Molecular Medicine Laboratory, International Centre for Genetic Engineering and Biotechnology (ICGEB), Trieste, Italy
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Rebecca Artioli
- Molecular Medicine Laboratory, International Centre for Genetic Engineering and Biotechnology (ICGEB), Trieste, Italy
- Department of Life Sciences, University of Trieste, Trieste, Italy
| | - Francesco Loffredo
- Department of Cardiothoracic Sciences, Monaldi Hospital, AORN Colli, Centro di Ricerca Cardiovascolare, Università della Campania 'Luigi Vanvitelli', Naples, Italy
| | - Saverio D'Elia
- Department of Cardiothoracic Sciences, Monaldi Hospital, AORN Colli, Centro di Ricerca Cardiovascolare, Università della Campania 'Luigi Vanvitelli', Naples, Italy
| | - Paolo Golino
- Department of Cardiothoracic Sciences, Monaldi Hospital, AORN Colli, Centro di Ricerca Cardiovascolare, Università della Campania 'Luigi Vanvitelli', Naples, Italy
| | - Enrico Fabris
- Cardiovascular Department, Center for Diagnosis and Treatment of Cardiomyopathies, Azienda Sanitaria Universitaria Giuliano-Isontina, University of Trieste, Trieste, Italy
- European Reference Network for Rare, Low-Prevalence, and Complex Diseases of the Heart (ERN GUARD-Heart)
| | - Rossana Bussani
- Cardiothoracic Department, Center for Diagnosis and Treatment of Cardiomyopathies, Institute of Pathological Anatomy and Histology, Azienda Sanitaria Universitaria Giuliano-Isontina, University of Trieste, Trieste, Italy
| | - Marco Metra
- Cardiology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Giuseppe Limongelli
- Department of Cardiothoracic Sciences, Monaldi Hospital, AORN Colli, Centro di Ricerca Cardiovascolare, Università della Campania 'Luigi Vanvitelli', Naples, Italy
| | - Gianfranco Sinagra
- Cardiovascular Department, Center for Diagnosis and Treatment of Cardiomyopathies, Azienda Sanitaria Universitaria Giuliano-Isontina, University of Trieste, Trieste, Italy
- European Reference Network for Rare, Low-Prevalence, and Complex Diseases of the Heart (ERN GUARD-Heart)
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Yang Y, Li W, You B, Zhou C. Advances in cell death mechanisms involved in viral myocarditis. Front Cardiovasc Med 2022; 9:968752. [PMID: 36017100 PMCID: PMC9395613 DOI: 10.3389/fcvm.2022.968752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 07/19/2022] [Indexed: 11/29/2022] Open
Abstract
Viral myocarditis is an acute inflammatory disease of the myocardium. Although many etiopathogenic factors exist, coxsackievirus B3 is a the leading cause of viral myocarditis. Abnormal cardiomyocyte death is the underlying problem for most cardiovascular diseases and fatalities. Various types of cell death occur and are regulated to varying degrees. In this review, we discuss the different cell death mechanisms in viral myocarditis and the potential interactions between them. We also explore the role and mechanism of cardiomyocyte death with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Exploring the mechanisms may help in the early identification and the development of effective treatments, thus improving the quality of life of patients with viral myocarditis. We believe that the inhibition of cardiomyocyte death has immense therapeutic potential in increasing the longevity and health of the heart.
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Affiliation(s)
- Yang Yang
- Taizhou People’s Hospital Affiliated to Nanjing Medical University, Taizhou, China
- Clinical Laboratory Center, Jiangsu Taizhou People’s Hospital, Taizhou, China
- *Correspondence: Yang Yang,
| | - Wang Li
- Taizhou People’s Hospital Affiliated to Nanjing Medical University, Taizhou, China
- Clinical Laboratory Center, Jiangsu Taizhou People’s Hospital, Taizhou, China
| | - Benshuai You
- School of Medicine, Jiangsu University, Zhenjiang, China
| | - Chenglin Zhou
- Taizhou People’s Hospital Affiliated to Nanjing Medical University, Taizhou, China
- Clinical Laboratory Center, Jiangsu Taizhou People’s Hospital, Taizhou, China
- Chenglin Zhou,
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3
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Long Q, Li L, Yang H, Lu Y, Yang H, Zhu Y, Tang Y, Liu C, Yuan J. SGLT2 inhibitor, canagliflozin, ameliorates cardiac inflammation in experimental autoimmune myocarditis. Int Immunopharmacol 2022; 110:109024. [PMID: 35841866 DOI: 10.1016/j.intimp.2022.109024] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 06/29/2022] [Accepted: 07/01/2022] [Indexed: 12/19/2022]
Abstract
Myocarditis is an inflammatory cardiovascular disease which contributes to dilated cardiomyopathy (DCM) and heart failure. Canagliflozin (CANA) exerts anti-inflammatory and cardioprotective effects in heart failure besides its hypoglycemic effect. However, the role of CANA in myocarditis has not been elucidated. In this work, CANA treatment markedly alleviated cardiac inflammation and improved cardiac function in experimental autoimmune myocarditis (EAM) mice induced by α-myosin-heavy chain peptides. The expressions of NLRP3 inflammasome complexes (NLRP3, ASC, and Caspase-1) and their downstream molecules (IL-1β, IL-18) were significantly downregulated by CANA, accompanied with reduced Th17 cell infiltration in hearts. Furthermore, Bax/Bcl-2 ratio, Cleaved Caspase-3 protein level and the percentage of TUNEL-positive myocardial cells, which usually indicated apoptosis, were reduced by CANA treatment. These findings suggest CANA could be a valuable medication for myocarditis treatment.
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Affiliation(s)
- Qi Long
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Lixia Li
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hongmin Yang
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yang Lu
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Han Yang
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yaoxi Zhu
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yaohan Tang
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Changhu Liu
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Yuan
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Peron D, Prates RA, Antonio EL, Teixeira ILA, de Oliveira HA, Mansano BSDM, Bergamo A, Almeida DR, Dariolli R, Tucci PJF, Serra AJ. A common oral pathogen Porphyromonas gingivalis induces myocarditis in rats. J Clin Periodontol 2022; 49:506-517. [PMID: 35066916 DOI: 10.1111/jcpe.13595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 11/22/2021] [Accepted: 01/17/2022] [Indexed: 11/29/2022]
Abstract
AIM To evaluate whether Porphyromonas gingivalis (P. gingivalis) inoculation could induce cardiac remodelling in rats. MATERIALS AND METHODS The study was conducted on 33 Wistar rats, which were distributed in the following experimental groups: not inoculated; inoculated with 1 × 108 CFU/ml of bacteria; inoculated with 3 × 108 CFU/ml of bacteria. The animals were inoculated at baseline and on the 15th day of follow-up. Blood collection was performed at baseline and 60 min after each inoculation. At 29 days, the animals were subjected to echocardiography and at 30 days to haemodynamic studies before sacrificing them. RESULTS Impact of the bacteria was more evident in rats that received higher P. gingivalis concentration. Thus, 3 × 108 CFU/ml of bacteria increased the rectal temperature and water content in the lung as well as myocardial necrosis and fibrosis. P. gingivalis induced the intensification of DNA fragmentation and increased the levels of malondialdehyde, oxidized proteins, and macrophage expression in the myocardium. These findings were associated with lower LV isovolumetric relaxation time, +dP/dt, -dP/dt, and higher end-diastolic pressure. CONCLUSIONS P. gingivalis bacteraemia is significantly associated with adverse cardiac remodelling and may play a biological role in the genesis of heart failure.
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Affiliation(s)
- Daniele Peron
- Biophotonics Applied to Health Science, Nove de Julho University, São Paulo, Brazil
| | - Renato Araujo Prates
- Biophotonics Applied to Health Science, Nove de Julho University, São Paulo, Brazil
| | - Ednei Luiz Antonio
- Department of Medicine, Cardiology Division, Federal University of São Paulo, São Paulo, Brazil
| | | | | | | | - Alexandre Bergamo
- Biophotonics Applied to Health Science, Nove de Julho University, São Paulo, Brazil
| | | | - Rafael Dariolli
- Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,PluriCell Biotech, São Paulo, Brazil
| | | | - Andrey Jorge Serra
- Department of Medicine, Cardiology Division, Federal University of São Paulo, São Paulo, Brazil
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5
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Ammirati E, Buono A, Moroni F, Gigli L, Power JR, Ciabatti M, Garascia A, Adler ED, Pieroni M. State-of-the-Art of Endomyocardial Biopsy on Acute Myocarditis and Chronic Inflammatory Cardiomyopathy. Curr Cardiol Rep 2022; 24:597-609. [PMID: 35201561 PMCID: PMC8866555 DOI: 10.1007/s11886-022-01680-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/10/2022] [Indexed: 12/11/2022]
Abstract
Purpose of Review Histologic evidence of myocardial inflammatory infiltrate not secondary to an ischemic injury is required by current diagnostic criteria to reach a definite diagnosis of myocarditis. Endomyocardial biopsy (EMB) is therefore often indicated for the diagnosis of myocarditis, although it may lack sufficient sensitivity considering the limited possibility of myocardial sampling. Improving the diagnostic yield and utility of EMB is of high priority in the fields of heart failure cardiology and myocarditis in particular. The aim of the present review is to highlight indications, strengths, and shortcomings of current EMB techniques, and discuss innovations currently being tested in ongoing clinical studies, especially in the setting of acute myocarditis and chronic inflammatory cardiomyopathy. Recent Findings EMB provides unique diagnostic elements and prognostic information which can effectively guide the treatment of myocarditis. Issues affecting the diagnostic performance in the setting of acute myocarditis and chronic inflammatory cardiomyopathies will be discussed in this review in the light of recent expert consensus documents on the management of these conditions and on indication to EMB. Recent innovations using electroanatomic mapping (EAM)-guided EMB and fluoroscopic-guided EMB during temporary mechanical circulatory support have improved the utility of the procedure. Summary EMB remains an important diagnostic test whose results need to be interpreted in the context of (1) clinical pre-test probability, (2) timing of sampling, (3) quality of sampling (4) site of sampling, (5) histologic type of myocarditis, and (6) analytic methods that are applied. Herein we will review these caveats as well as perspectives and innovations related to the use of this diagnostic tool.
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Affiliation(s)
- Enrico Ammirati
- De Gasperis" Cardio Center and Transplant Center, Niguarda Hospital, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 3, 20162, Milan, Italy.
| | - Andrea Buono
- Interventional Cardiology Unit, Cardiovascular Department, Fondazione Poliambulanza, Brescia, Italy
| | | | - Lorenzo Gigli
- De Gasperis" Cardio Center and Transplant Center, Niguarda Hospital, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 3, 20162, Milan, Italy
| | - John R Power
- Division of Cardiology, Department of Medicine, University of California San Diego, San Diego, CA, USA
| | - Michele Ciabatti
- Cardiovascular Department, ASL8 Arezzo San Donato Hospital, Arezzo, Italy
| | - Andrea Garascia
- De Gasperis" Cardio Center and Transplant Center, Niguarda Hospital, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 3, 20162, Milan, Italy
| | - Eric D Adler
- Division of Cardiology, Department of Medicine, University of California San Diego, San Diego, CA, USA
| | - Maurizio Pieroni
- Cardiovascular Department, ASL8 Arezzo San Donato Hospital, Arezzo, Italy
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6
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Myocardial Damage by SARS-CoV-2: Emerging Mechanisms and Therapies. Viruses 2021; 13:v13091880. [PMID: 34578462 PMCID: PMC8473126 DOI: 10.3390/v13091880] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/06/2021] [Accepted: 09/18/2021] [Indexed: 01/01/2023] Open
Abstract
Evidence is emerging that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can infect various organs of the body, including cardiomyocytes and cardiac endothelial cells in the heart. This review focuses on the effects of SARS-CoV-2 in the heart after direct infection that can lead to myocarditis and an outline of potential treatment options. The main points are: (1) Viral entry: SARS-CoV-2 uses specific receptors and proteases for docking and priming in cardiac cells. Thus, different receptors or protease inhibitors might be effective in SARS-CoV-2-infected cardiac cells. (2) Viral replication: SARS-CoV-2 uses RNA-dependent RNA polymerase for replication. Drugs acting against ssRNA(+) viral replication for cardiac cells can be effective. (3) Autophagy and double-membrane vesicles: SARS-CoV-2 manipulates autophagy to inhibit viral clearance and promote SARS-CoV-2 replication by creating double-membrane vesicles as replication sites. (4) Immune response: Host immune response is manipulated to evade host cell attacks against SARS-CoV-2 and increased inflammation by dysregulating immune cells. Efficiency of immunosuppressive therapy must be elucidated. (5) Programmed cell death: SARS-CoV-2 inhibits programmed cell death in early stages and induces apoptosis, necroptosis, and pyroptosis in later stages. (6) Energy metabolism: SARS-CoV-2 infection leads to disturbed energy metabolism that in turn leads to a decrease in ATP production and ROS production. (7) Viroporins: SARS-CoV-2 creates viroporins that lead to an imbalance of ion homeostasis. This causes apoptosis, altered action potential, and arrhythmia.
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7
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Wang Q, Zhu Q, Ye Q, Wang J, Dong Q, Chen Y, Wang M, Fu Y, Wu R, Wu T. STAT3 Suppresses Cardiomyocytes Apoptosis in CVB3-Induced Myocarditis Via Survivin. Front Pharmacol 2021; 11:613883. [PMID: 33658937 PMCID: PMC7919905 DOI: 10.3389/fphar.2020.613883] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 12/07/2020] [Indexed: 12/24/2022] Open
Abstract
Background: Viral myocarditis (VMC) is a common inflammatory cardiovascular disease with unclear mechanisms, which mainly affects children and adolescents. Apoptosis is the key to CVB3-induced myocarditis, and blocking this process may be beneficial to the therapy of VMC. Hence, this study aimed to explore the protective function of STAT3 on cardiomyocyte apoptosis of VMC and its underlying mechanisms. Methods and Results: In this research, we confirmed that STAT3 was significantly activated in both animal and cell models of VMC. To further clarify what role did STAT3 play in VMC, AG490, an inhibitor of STAT3, was used to suppress p-STAT3. Our results demonstrated that decreased expression of p-STAT3 caused by AG490 significantly aggravated severity of VMC with elevated myocardial inflammation, deteriorative ventricular systolic function and increased mortality. It suggested that STAT3 plays a protective role in VMC. To further identify the anti-apoptosis impact that activated STAT3 made, we constructed lentivirus to regulate the expression of STAT3 in NMCs. We found that up-regulated activated STAT3 attenuated cardiomyocyte apoptosis, but down-regulated one aggravated that, which verified activated STAT3 played an anti-apoptosis role in VMC. Following that, we explored what elements are involved in the anti-apoptotic mechanism of activated STAT3 by using survivin inhibitor YM155. The result showed the anti-apoptotic effect of activated STAT3 does not work in the case of survivin inhibition. Conclusion: Our findings demonstrated STAT3 by targeting survivin alleviated cardiomyocyte apoptosis in CVB3-induced myocarditis.
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Affiliation(s)
- Qiaoyu Wang
- Children's Heart Center, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Qiongjun Zhu
- Children's Heart Center, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Qiaofang Ye
- Children's Heart Center, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Jiajun Wang
- Children's Heart Center, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Qianqian Dong
- Children's Heart Center, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Youran Chen
- Children's Heart Center, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Minna Wang
- Children's Heart Center, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yu Fu
- Children's Heart Center, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Rongzhou Wu
- Children's Heart Center, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Tingting Wu
- Children's Heart Center, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
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8
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Cardiac apoptosis caused by elevated cholesterol level in experimental autoimmune myocarditis. Exp Cell Res 2020; 395:112169. [PMID: 32653410 DOI: 10.1016/j.yexcr.2020.112169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 07/02/2020] [Accepted: 07/06/2020] [Indexed: 11/21/2022]
Abstract
It has been reported that cholesterol-lowing agents can ameliorate severity of myocarditis. However, the beneficial effect of the agents has been claimed to be independent of cholesterol reduction as there is no significant change in the plasma cholesterol level in myocarditis. In the present study, using experimental autoimmune myocarditis (EAM) rats as an animal model, we demonstrated that EAM induced elevation of cholesterol level and impaired cholesterol efflux capacity in the cardiac tissue. Moreover, serum high-density lipoprotein (HDL) content was reduced and HDL function associated protein Paraoxonase 1 (PON1) activity was decreased. Besides, the major structural protein within HDL, Apolipoprotein A1 (ApoA1) expression in the cardiac tissues was significantly reduced while the level of serum ApoA1 was not significantly altered. Importantly, cholesterol depleting agent methyl-β-cyclodextrin (MβCD) alleviated the development of EAM, as monitored by decreased ratio of heart weight to body weight (HW/BW), decreased infiltration of inflammatory cells and collagen deposition, improved cardiac function, reduced expression of apoptosis-related protein Bax, Fas, FasL and caspase-3 and increased level of anti-apoptotic protein Bcl-2. These results suggest that reduction of cholesterol level in cardiac tissue could suppress EAM-induced cardiac apoptosis through both intrinsic and extrinsic apoptotic pathways.
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9
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Wu R, Wu T, Li P, Wang Q, Shi Y, Zhan Y, Zhang S, Xia T, Wang Z, Lv H. The protection effects of survivin in the cell model of CVB3-induced viral myocarditis. Heart Vessels 2020; 35:1171-1179. [PMID: 32328712 DOI: 10.1007/s00380-020-01607-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 04/10/2020] [Indexed: 01/24/2023]
Abstract
Viral myocarditis (VMC) is a widely studied but poorly understood inflammatory cardiomyopathy which mainly affects children and young adults and results in adverse outcomes. Cardiomyocyte apoptosis was reported important in the progress of coxsackievirus B3 (CVB3)-induced VMC and the blocking of this process may contribute to the therapeutic effect towards VMC. Therefore, this study was designed to explore whether survivin, one of the strongest antiapoptotic proteins, can protect cardiomyocytes from apoptosis in VMC and to discover its related mechanisms. Here, the cultured neonatal mouse cardiomyocytes (NMCs) were exposed to CVB3 to establish the cell model of VMC and the results of Western Blot showed that the protein expression of survivin in CVB3-infected NMCs varied at different post-infection time. Lentivirus was next used to examine the function of survivin in CVB3-infected NMCs. TUNEL assay demonstrated that the overexpression of survivin interrupted CVB3-induced apoptosis. It was next examined whether caspase-3 and -9 were involved in the antiapoptotic pathway initiated by survivin via Western Blot. The results showed a reverse relationship between the protein expression of survivin and that of cleaved caspase-3 and cleaved caspase-9, suggesting that survivin may attenuate apoptosis through restraining the activity of caspase-3 and -9. Moreover, the supernatant fluid of cultured NMCs was extracted to detect the quantitation of released lactate dehydrogenase (LDH) and a sharp decrease was discovered in the survivin-overexpressed group compared to the CVB3-infected group, indicating a protective role of survivin in the cell model of CVB3-induced myocarditis. This study demonstrated that survivin was triggered by CVB3 infection in NMCs and survivin executed its antiapoptotic effects via caspase-3- and caspase-9-dependent signaling pathway.
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Affiliation(s)
- Rongzhou Wu
- Department of Pediatric Cardiology, Children's Hospital of Soochow University, Suzhou, 215025, China
- Children's Heart Center, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Institute of Cardiovascular Development and Translational Medicine, The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325027, Zhejiang, China
| | - Tingting Wu
- Children's Heart Center, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Institute of Cardiovascular Development and Translational Medicine, The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325027, Zhejiang, China
| | - Ping Li
- Children's Heart Center, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Institute of Cardiovascular Development and Translational Medicine, The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325027, Zhejiang, China
| | - Qiaoyu Wang
- Children's Heart Center, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Institute of Cardiovascular Development and Translational Medicine, The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325027, Zhejiang, China
| | - Youyang Shi
- Children's Heart Center, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Institute of Cardiovascular Development and Translational Medicine, The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325027, Zhejiang, China
| | - Yi Zhan
- Children's Heart Center, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Institute of Cardiovascular Development and Translational Medicine, The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325027, Zhejiang, China
| | - Songyue Zhang
- Children's Heart Center, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Institute of Cardiovascular Development and Translational Medicine, The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325027, Zhejiang, China
| | - Tianhe Xia
- Children's Heart Center, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Institute of Cardiovascular Development and Translational Medicine, The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325027, Zhejiang, China
| | - Zhenquan Wang
- Children's Heart Center, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Institute of Cardiovascular Development and Translational Medicine, The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325027, Zhejiang, China
| | - Haitao Lv
- Department of Pediatric Cardiology, Children's Hospital of Soochow University, Suzhou, 215025, China.
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Wang R, Li D, Ouyang J, Tian X, Zhao Y, Peng X, Li S, Yu G, Yang J. Leonurine alleviates LPS-induced myocarditis through suppressing the NF-кB signaling pathway. Toxicology 2019; 422:1-13. [DOI: 10.1016/j.tox.2019.04.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 03/20/2019] [Accepted: 04/16/2019] [Indexed: 12/30/2022]
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Zhou F, Jiang X, Teng L, Yang J, Ding J, He C. Necroptosis may be a novel mechanism for cardiomyocyte death in acute myocarditis. Mol Cell Biochem 2017; 442:11-18. [PMID: 28887702 DOI: 10.1007/s11010-017-3188-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 09/01/2017] [Indexed: 01/30/2023]
Abstract
In this study, we investigated the roles of RIP1/RIP3 mediated cardiomyocyte necroptosis in CVB3-induced acute myocarditis. Serum concentrations of creatinine kinase (CK), CK-MB, and cardiac troponin I were detected using a Hitachi Automatic Biochemical Analyzer in a mouse model of acute VMC. Histological changes in cardiac tissue were observed by light microscope and expression levels of RIP1/RIP3 in the cardiac tissue were detected via Western blot and immunohistochemistry. The data showed that RIP1/RIP3 was highly expressed in cardiomyocytes in the acute VMC mouse model and that the necroptosis pathway specific blocker, Nec-1, dramatically reduced the myocardial damage by downregulating the expression of RIP1/RIP3. These findings provide evidence that necroptosis plays a significant role in cardiomyocyte death and it is a major pathway for cell death in acute VMC. Blocking the necroptosis pathway may serve as a new therapeutic option for the treatment of acute viral myocarditis.
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Affiliation(s)
- Fei Zhou
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei Province, China
| | - Xuejun Jiang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei Province, China.
| | - Lin Teng
- Department of Cardiology, The First College of Clinical Medical Sciences, China Three Gorges University, Yichang, 443003, Hubei Province, China
| | - Jun Yang
- Department of Cardiology, The First College of Clinical Medical Sciences, China Three Gorges University, Yichang, 443003, Hubei Province, China
| | - Jiawang Ding
- Department of Cardiology, The First College of Clinical Medical Sciences, China Three Gorges University, Yichang, 443003, Hubei Province, China
| | - Chao He
- Department of Cardiology, The First College of Clinical Medical Sciences, China Three Gorges University, Yichang, 443003, Hubei Province, China
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12
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Mbogo GW, Nedeva C, Puthalakath H. Isolation of Cardiomyocytes and Cardiofibroblasts for Ex Vivo Analysis. Methods Mol Biol 2016; 1419:117-29. [PMID: 27108436 DOI: 10.1007/978-1-4939-3581-9_10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Heart failure (HF) is a common clinical endpoint to several underlying causes including aging, hypertension, stress, and cardiomyopathy. It is characterized by a significant decline in the cardiac output. Cardiomyocytes are terminally differentiated cells and therefore, apoptotic death due to beta adrenergic (β-AR) signaling contributes to high attrition rate of these cells. Past treatments of HF offer some survival benefit to patients (e.g., the beta blockers), but at the expense of blocking the compensatory beta-adrenergic signaling in surviving cells. One prerequisite for developing new therapeutics is to be able to grow cardiomyocytes ex vivo, and test their apoptotic response to drugs. Here we describe methods for isolation and culturing of neonatal and adult calcium tolerant cardiomyocytes. Similarly, cardiofibroblasts can also be isolated using the same protocol and subsequently, immortalized with SV40 T-Antigen for ex vivo studies.
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Affiliation(s)
- George Williams Mbogo
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Christina Nedeva
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Hamsa Puthalakath
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science, La Trobe University, Melbourne, VIC, 3086, Australia.
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13
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Myocardial apoptosis and SIDS. Forensic Sci Int 2014; 246:1-5. [PMID: 25460101 DOI: 10.1016/j.forsciint.2014.10.045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 10/15/2014] [Accepted: 10/30/2014] [Indexed: 11/21/2022]
Abstract
Apoptosis mediates cardiac damage in severe forms of myocarditis. In fatal myocarditis, large amounts of cardiomyocytes show apoptotic DNA fragmentation, while in human controls, few apoptotic cardiomyocytes are found. In the present study the frequency of apoptosis in 88 SIDS cases (category 1b according to the San Diego Classification) and 15 control cases was investigated. In every case myocardial samples from 8 standard locations were collected. Detection of apoptotic cardiomyocytes was performed by TUNEL method. Furthermore the myocardial tissue was stained with HE and immunohistochemical methods (LCA, CD68, CD45-R0). More than 90% of the slides did not contain apoptotic cardiomyocytes at all. The detection rate of apoptotic cardiomyocytes was almost equal in control group (26.7%) and SIDS group (23.86%). A quantification of apoptotic cardiomyocytes per mm(2) revealed no significant difference between both groups either. Altogether there is no evidence for a higher rate of apoptosis in SIDS.
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14
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Youn JC, Shim HS, Lee JS, Ji AY, Oh J, Hong N, Lee HS, Park S, Lee SH, Choi D, Chung N, Kang SM. Detailed pathologic evaluation on endomyocardial biopsy provides long-term prognostic information in patients with acute myocarditis. Cardiovasc Pathol 2014; 23:139-44. [PMID: 24529879 DOI: 10.1016/j.carpath.2014.01.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2013] [Revised: 01/09/2014] [Accepted: 01/10/2014] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The long-term prognosis of biopsy-proven myocarditis is not well known. We hypothesized that a detailed pathological examination of an endomyocardial biopsy (EMB) would reveal prognostic information in patients with acute myocarditis. METHODS Fifty-four patients were diagnosed with acute myocarditis based on an EMB. Pathological diagnosis was categorized into lymphocytic dominant (29.6%), eosinophilic dominant (22.2%), and borderline myocarditis (48.1%). Masson's trichrome staining and further immunohistochemical staining for CD3, CD20, CD68, HLA-DR, TLR4, TLR8, enteroviral VP1, and caspase-3 expression were performed. The clinical outcomes were defined as all-cause and cardiovascular (CV) death. RESULTS During the median 10.4 years of follow up (9.7±5.7 years), the overall all-cause mortality was 20.4% and the CV mortality was 14.8% in patients with acute myocarditis. Lymphocytic dominant myocarditis patients showed a poor clinical outcome when compared with eosinophilic dominant myocarditis patients for both all-cause (37.5% vs. 0%, p=0.015) and CV (31.2% vs. 0%, p=0.029) mortality. Among borderline myocarditis patients, the presence of fibrosis was linked with poor clinical outcomes in both all-cause (75.0% vs. 21.4%, p=0.045) and CV (100.0% vs. 25.0%, p=0.034) mortality. No significant associations between clinical outcome and all other immunohistochemical staining targets were observed. CONCLUSIONS Detailed pathological evaluation on an EMB provides prognostic information in patients with acute myocarditis. EMB evaluation should be considered in patients with suspected myocarditis.
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Affiliation(s)
- Jong-Chan Youn
- Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Hyo Sup Shim
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.
| | - Jae Seok Lee
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
| | - Ah-Young Ji
- Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Jaewon Oh
- Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Namki Hong
- Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Hye Sun Lee
- Department of Biostatistics, Yonsei University College of Medicine, Seoul, Korea
| | - Sungha Park
- Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Sang-Hak Lee
- Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Donghoon Choi
- Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Namsik Chung
- Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Seok-Min Kang
- Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea; Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea.
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15
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Toldo S, Kannan H, Bussani R, Anzini M, Sonnino C, Sinagra G, Merlo M, Mezzaroma E, De-Giorgio F, Silvestri F, Van Tassell BW, Baldi A, Abbate A. Formation of the inflammasome in acute myocarditis. Int J Cardiol 2014; 171:e119-21. [PMID: 24439778 DOI: 10.1016/j.ijcard.2013.12.137] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Accepted: 12/20/2013] [Indexed: 01/14/2023]
Affiliation(s)
- Stefano Toldo
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA; Victoria Johnson Research Laboratories, Virginia Commonwealth University, Richmond, VA, USA
| | - Harsha Kannan
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA; Victoria Johnson Research Laboratories, Virginia Commonwealth University, Richmond, VA, USA
| | - Rossana Bussani
- Institute of Pathologic Anatomy, University of Trieste, Trieste, Italy
| | - Marco Anzini
- Cardiovascular Department "Ospedali Riuniti", University of Trieste, Trieste, Italy
| | - Chiara Sonnino
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA; Victoria Johnson Research Laboratories, Virginia Commonwealth University, Richmond, VA, USA
| | - Gianfranco Sinagra
- Cardiovascular Department "Ospedali Riuniti", University of Trieste, Trieste, Italy
| | - Marco Merlo
- Cardiovascular Department "Ospedali Riuniti", University of Trieste, Trieste, Italy
| | - Eleonora Mezzaroma
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA; Victoria Johnson Research Laboratories, Virginia Commonwealth University, Richmond, VA, USA; Department of Pharmacotherapy and Outcomes Studies, Virginia Commonwealth University, Richmond, VA, USA
| | | | - Furio Silvestri
- Institute of Pathologic Anatomy, University of Trieste, Trieste, Italy
| | - Benjamin W Van Tassell
- Victoria Johnson Research Laboratories, Virginia Commonwealth University, Richmond, VA, USA; Department of Pharmacotherapy and Outcomes Studies, Virginia Commonwealth University, Richmond, VA, USA
| | - Alfonso Baldi
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, Second University of Naples, Italy
| | - Antonio Abbate
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA; Victoria Johnson Research Laboratories, Virginia Commonwealth University, Richmond, VA, USA.
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16
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Anzini M, Merlo M, Sabbadini G, Barbati G, Finocchiaro G, Pinamonti B, Salvi A, Perkan A, Di Lenarda A, Bussani R, Bartunek J, Sinagra G. Long-Term Evolution and Prognostic Stratification of Biopsy-Proven Active Myocarditis. Circulation 2013; 128:2384-94. [DOI: 10.1161/circulationaha.113.003092] [Citation(s) in RCA: 124] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Marco Anzini
- From the Cardiovascular Department, “Ospedali Riuniti di Trieste” and University of Trieste, Trieste, Italy (M.A., M.M., G.S., G.B., G.F., B.P., A.S., A.P., G.S.); Cardiovascular Centre, Azienda per Servizi Sanitari no. 1 Triestina, Trieste, Italy (A.D.L.); Institute of Pathological Anatomy and Histology, “Ospedali Riuniti di Trieste” and University of Trieste, Trieste, Italy (R.B.); and Cardiovascular Centre Aalst, OLV Clinic, Aalst, Belgium (J.B.)
| | - Marco Merlo
- From the Cardiovascular Department, “Ospedali Riuniti di Trieste” and University of Trieste, Trieste, Italy (M.A., M.M., G.S., G.B., G.F., B.P., A.S., A.P., G.S.); Cardiovascular Centre, Azienda per Servizi Sanitari no. 1 Triestina, Trieste, Italy (A.D.L.); Institute of Pathological Anatomy and Histology, “Ospedali Riuniti di Trieste” and University of Trieste, Trieste, Italy (R.B.); and Cardiovascular Centre Aalst, OLV Clinic, Aalst, Belgium (J.B.)
| | - Gastone Sabbadini
- From the Cardiovascular Department, “Ospedali Riuniti di Trieste” and University of Trieste, Trieste, Italy (M.A., M.M., G.S., G.B., G.F., B.P., A.S., A.P., G.S.); Cardiovascular Centre, Azienda per Servizi Sanitari no. 1 Triestina, Trieste, Italy (A.D.L.); Institute of Pathological Anatomy and Histology, “Ospedali Riuniti di Trieste” and University of Trieste, Trieste, Italy (R.B.); and Cardiovascular Centre Aalst, OLV Clinic, Aalst, Belgium (J.B.)
| | - Giulia Barbati
- From the Cardiovascular Department, “Ospedali Riuniti di Trieste” and University of Trieste, Trieste, Italy (M.A., M.M., G.S., G.B., G.F., B.P., A.S., A.P., G.S.); Cardiovascular Centre, Azienda per Servizi Sanitari no. 1 Triestina, Trieste, Italy (A.D.L.); Institute of Pathological Anatomy and Histology, “Ospedali Riuniti di Trieste” and University of Trieste, Trieste, Italy (R.B.); and Cardiovascular Centre Aalst, OLV Clinic, Aalst, Belgium (J.B.)
| | - Gherardo Finocchiaro
- From the Cardiovascular Department, “Ospedali Riuniti di Trieste” and University of Trieste, Trieste, Italy (M.A., M.M., G.S., G.B., G.F., B.P., A.S., A.P., G.S.); Cardiovascular Centre, Azienda per Servizi Sanitari no. 1 Triestina, Trieste, Italy (A.D.L.); Institute of Pathological Anatomy and Histology, “Ospedali Riuniti di Trieste” and University of Trieste, Trieste, Italy (R.B.); and Cardiovascular Centre Aalst, OLV Clinic, Aalst, Belgium (J.B.)
| | - Bruno Pinamonti
- From the Cardiovascular Department, “Ospedali Riuniti di Trieste” and University of Trieste, Trieste, Italy (M.A., M.M., G.S., G.B., G.F., B.P., A.S., A.P., G.S.); Cardiovascular Centre, Azienda per Servizi Sanitari no. 1 Triestina, Trieste, Italy (A.D.L.); Institute of Pathological Anatomy and Histology, “Ospedali Riuniti di Trieste” and University of Trieste, Trieste, Italy (R.B.); and Cardiovascular Centre Aalst, OLV Clinic, Aalst, Belgium (J.B.)
| | - Alessandro Salvi
- From the Cardiovascular Department, “Ospedali Riuniti di Trieste” and University of Trieste, Trieste, Italy (M.A., M.M., G.S., G.B., G.F., B.P., A.S., A.P., G.S.); Cardiovascular Centre, Azienda per Servizi Sanitari no. 1 Triestina, Trieste, Italy (A.D.L.); Institute of Pathological Anatomy and Histology, “Ospedali Riuniti di Trieste” and University of Trieste, Trieste, Italy (R.B.); and Cardiovascular Centre Aalst, OLV Clinic, Aalst, Belgium (J.B.)
| | - Andrea Perkan
- From the Cardiovascular Department, “Ospedali Riuniti di Trieste” and University of Trieste, Trieste, Italy (M.A., M.M., G.S., G.B., G.F., B.P., A.S., A.P., G.S.); Cardiovascular Centre, Azienda per Servizi Sanitari no. 1 Triestina, Trieste, Italy (A.D.L.); Institute of Pathological Anatomy and Histology, “Ospedali Riuniti di Trieste” and University of Trieste, Trieste, Italy (R.B.); and Cardiovascular Centre Aalst, OLV Clinic, Aalst, Belgium (J.B.)
| | - Andrea Di Lenarda
- From the Cardiovascular Department, “Ospedali Riuniti di Trieste” and University of Trieste, Trieste, Italy (M.A., M.M., G.S., G.B., G.F., B.P., A.S., A.P., G.S.); Cardiovascular Centre, Azienda per Servizi Sanitari no. 1 Triestina, Trieste, Italy (A.D.L.); Institute of Pathological Anatomy and Histology, “Ospedali Riuniti di Trieste” and University of Trieste, Trieste, Italy (R.B.); and Cardiovascular Centre Aalst, OLV Clinic, Aalst, Belgium (J.B.)
| | - Rossana Bussani
- From the Cardiovascular Department, “Ospedali Riuniti di Trieste” and University of Trieste, Trieste, Italy (M.A., M.M., G.S., G.B., G.F., B.P., A.S., A.P., G.S.); Cardiovascular Centre, Azienda per Servizi Sanitari no. 1 Triestina, Trieste, Italy (A.D.L.); Institute of Pathological Anatomy and Histology, “Ospedali Riuniti di Trieste” and University of Trieste, Trieste, Italy (R.B.); and Cardiovascular Centre Aalst, OLV Clinic, Aalst, Belgium (J.B.)
| | - Jozef Bartunek
- From the Cardiovascular Department, “Ospedali Riuniti di Trieste” and University of Trieste, Trieste, Italy (M.A., M.M., G.S., G.B., G.F., B.P., A.S., A.P., G.S.); Cardiovascular Centre, Azienda per Servizi Sanitari no. 1 Triestina, Trieste, Italy (A.D.L.); Institute of Pathological Anatomy and Histology, “Ospedali Riuniti di Trieste” and University of Trieste, Trieste, Italy (R.B.); and Cardiovascular Centre Aalst, OLV Clinic, Aalst, Belgium (J.B.)
| | - Gianfranco Sinagra
- From the Cardiovascular Department, “Ospedali Riuniti di Trieste” and University of Trieste, Trieste, Italy (M.A., M.M., G.S., G.B., G.F., B.P., A.S., A.P., G.S.); Cardiovascular Centre, Azienda per Servizi Sanitari no. 1 Triestina, Trieste, Italy (A.D.L.); Institute of Pathological Anatomy and Histology, “Ospedali Riuniti di Trieste” and University of Trieste, Trieste, Italy (R.B.); and Cardiovascular Centre Aalst, OLV Clinic, Aalst, Belgium (J.B.)
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17
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Philip J, Xu Z, Bowles NE, Vallejo JG. Cardiac-specific overexpression of melanoma differentiation-associated gene-5 protects mice from lethal viral myocarditis. Circ Heart Fail 2012; 6:326-34. [PMID: 23271791 DOI: 10.1161/circheartfailure.112.969402] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Viral myocarditis is among the most common causes of heart failure in children and young adults. The RNA helicase melanoma differentiation-associated gene-5 (MDA5) is critical for host antiviral responses against members of the Picornaviridae family, such as encephalomyocarditis virus (EMCV). MDA5-knockout mice are highly susceptible to EMCV infection and develop significant myocardial injury and left ventricular dysfunction. However, the mechanisms by which MDA5 signaling within cardiac myocytes contributes to the host response against viral infection have not been defined. METHODS AND RESULTS We generated cardiac-specific MDA5 transgenic (alpha-myosin heavy chain [αMHC]-MDA5) mice. These mice showed increased baseline cardiac expression of antiviral cytokines and increased cellular infiltration but no alterations in cardiac function and structure. αMHC-MDA5 mice were less susceptible to EMCV infection and had a significantly lower cardiac viral load compared with littermate control mice. The severity of myocarditis, prevalence of cardiac myocyte apoptosis, and cleavage of caspase 3 after EMCV infection were attenuated in αMHC-MDA5 mice. Furthermore, αMHC-MDA5 mice were protected against EMCV-induced myocardial dysfunction. CONCLUSIONS Our data suggest that myocardial MDA5 may be a key molecule in protecting the heart from direct viral injury and myocardial dysfunction.
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Affiliation(s)
- Joseph Philip
- Department of Pediatrics, Sections of Infectious Diseases, and Critical Care Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, TX 77030, USA
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18
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Weerasinghe P, Hallock S, Brown RE, Loose DS, Buja LM. A model for cardiomyocyte cell death: insights into mechanisms of oncosis. Exp Mol Pathol 2012; 94:289-300. [PMID: 22609242 DOI: 10.1016/j.yexmp.2012.04.022] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Accepted: 04/05/2012] [Indexed: 11/16/2022]
Abstract
It is now known that there are at least two basic patterns of cell injury progressing to cell death: cell injury with swelling, known as oncosis, and cell injury with shrinkage, known as apoptosis. Both types of cell death are "programmed" in the sense that the genetic information and many of the enzymes and other factors pre-exist in the cell. Previous investigation has pointed to cardiomyocyte ischemic injury evolving as the oncotic pattern of injury, although apoptosis has also been implicated. This study was designed, using a unique cell model system, to gain insight into the molecular events of anticancer agent-induced cardiomyocyte injury. Cardiomyocytes exposed for 2 h to 1.5 μg/ml sanguinarine consistently displayed the morphology of apoptosis in over 80% of cells, whereas a higher dose of 25 μg/ml at 2 h yielded the pattern of oncosis in over 90% of cells. Microarray analysis revealed altered expression of 2514 probes in sanguinarine-induced oncosis and 1643 probes in apoptosis at a level of significance of p<0.001. Some of the inductions such as perforin were found to be higher than 11-fold in oncosis. When perforin was blocked by perforin-specific siRNA we found a reduction in oncotic cell death. These results strengthen the notion that oncosis is not representative of nonspecific necrosis, but constitutes a genetically controlled form of "programmed cell death"; and also that oncosis might represent a pathogenetic mechanism of cardiomyocyte injury. This is also the first demonstration of the involvement of perforin in cardiomyocyte oncosis.
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Affiliation(s)
- Priya Weerasinghe
- University of Texas Health Sciences Center Houston, Department of Pathology and Laboratory Medicine, Houston, TX, USA.
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19
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Blagonravov ML. Induction of caspase cascade as a nonspecific response to myocardial damage. Bull Exp Biol Med 2012; 151:167-70. [PMID: 22238742 DOI: 10.1007/s10517-011-1281-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In three experimental series, acute hemodynamic overload of the left ventricle, focal ischemia of the left ventricle, and diphtheritic intoxication were modeled in rabbits. On days 1, 3, and 5 of the experiments, activity of myocardial caspase-3 and caspase-8 were measured separately in the left and right ventricles. In the left ventricle, caspase-3 activity increased in all 3 modeled pathological processes, while in the right ventricle this parameter increased during acute overload and ischemic injury to the left ventricle. Caspase-8 activity increased only in the left ventricle during its hemodynamic overload and remained unchanged in other cases. It was concluded that induction of the caspase cascade can be considered as a nonspecific response to myocardial damage. In this case, specific mechanisms responsible for generation and transmission of apoptotic stimuli in cardiomyocytes have unique features.
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Affiliation(s)
- M L Blagonravov
- Department of General Pathology and Pathophysiology, People's Friendship University of Russia, Moscow, Russia.
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20
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The mitochondrial respiratory chain has a critical role in the antiviral process in Coxsackievirus B3-induced myocarditis. J Transl Med 2012; 92:125-34. [PMID: 21968812 DOI: 10.1038/labinvest.2011.145] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Well-established differences in Coxsackievirus B3 (CVB3) elimination in resistant C57BL/6 and permissive A.SW/SnJ mice provide suitable models for studying the significance of the link between mitochondrial respiratory chain (RC), antioxidative stress components and mitochondrion-related apoptosis in the context of myocardial virus elimination. Distinct myocardial CVB3 titer in C57BL/6 (2.5 ± 1.4 × 10(4) plaque-forming units (p.f.u.)/g tissue) and A.SW/SnJ mice (1.4 ± 0.8 × 10(7) p.f.u./g) were associated with differences in the cardiac mitochondrial function 8 days post infection (p.i.). Infected C57BL/6 mouse hearts disclosed increased complex I (CI) and CIII activity, but restricted CII and normal CIV activity of RC. Reduced expression of the antioxidative catalase was accompanied by elevated lipid peroxidation (LPO), indicating oxidative stress. Intrinsic apoptosis was activated demonstrated by elevated levels of Bax, Bcl-2, caspase 3 and DNA degradation. In contrast, all myocardial RC complex activities were restricted in CVB3-infected A.SW/SnJ mice. The antioxidative system provided sufficient protection against oxidative stress shown by an elevated catalase expression and unaltered LPO. Bax and Bcl-2 levels were unchanged in CVB3-infected A.SW/SnJ mice, while caspase 3 was moderately increased but no DNA degradation was detectable. Correlation analyses including data from the two mouse strains revealed that reduced CVB3 titer correlated with increased CI and CIII activity, oxidative stress as well as active apoptosis during acute myocarditis (MC). C57BL/6 mice completely eliminated CVB3 and inflammation and normalized all intracellular parameters, while A.SW/SnJ mice showed permanently restricted CI activity in chronic MC 90 days p.i., at which time the replicating virus was no longer detectable but immunological processes were still active. Consequently, the regulation of energy metabolism appears crucial for an effective virus elimination and may be of prognostic and therapeutic significance for patients with virus-induced MC.
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21
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Winston B, Nalesnik M, Bazaz R. TUNEL assay for identifying ablated myocardium. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2010; 33:1548-9. [PMID: 20825561 DOI: 10.1111/j.1540-8159.2010.02883.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The terminal deoxynucleotidyl transferase biotin-dUTP nick end labeling (TUNEL) assay identifies apoptosis and is used in transplant pathology to detect cardiac allograft rejection. We illustrate the use of TUNEL in identifying segments of ablated ventricular myocardium, and discuss its advantages over conventional histopathological stains. The TUNEL assay can be useful to investigators of catheter ablation therapy.
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Affiliation(s)
- Brion Winston
- University of Pittsburgh Medical Center, Presbyterian Hospital, Pittsburgh, PA 15213, USA.
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22
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Coxsackievirus B3 infection activates the unfolded protein response and induces apoptosis through downregulation of p58IPK and activation of CHOP and SREBP1. J Virol 2010; 84:8446-59. [PMID: 20554776 DOI: 10.1128/jvi.01416-09] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Cardiomyocyte apoptosis is a hallmark of coxsackievirus B3 (CVB3)-induced myocarditis. We used cardiomyocytes and HeLa cells to explore the cellular response to CVB3 infection, with a focus on pathways leading to apoptosis. CVB3 infection triggered endoplasmic reticulum (ER) stress and differentially regulated the three arms of the unfolded protein response (UPR) initiated by the proximal ER stress sensors ATF6a (activating transcription factor 6a), IRE1-XBP1 (X box binding protein 1), and PERK (PKR-like ER protein kinase). Upon CVB3 infection, glucose-regulated protein 78 expression was upregulated, and in turn ATF6a and XBP1 were activated via protein cleavage and mRNA splicing, respectively. UPR activity was further confirmed by the enhanced expression of UPR target genes ERdj4 and EDEM1. Surprisingly, another UPR-associated gene, p58(IPK), which often is upregulated during infections with other types of viruses, was downregulated at both mRNA and protein levels after CVB3 infection. These findings were observed similarly for uninfected Tet-On HeLa cells induced to overexpress ATF6a or XBP1. In exploring potential connections between the three UPR pathways, we found that the ATF6a-induced downregulation of p58(IPK) was associated with the activation of PKR (PERK) and the phosphorylation of eIF2alpha, suggesting that p58(IPK), a negative regulator of PERK and PKR, mediates cross-talk between the ATF6a/IRE1-XBP1 and PERK arms. Finally, we found that CVB3 infection eventually produced the induction of the proapoptoic transcription factor CHOP and the activation of SREBP1 and caspase-12. Taken together, these data suggest that CVB3 infection activates UPR pathways and induces ER stress-mediated apoptosis through the suppression of P58(IPK) and induction/activation of CHOP, SREBP1, and caspase-12.
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