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Federspiel JM, Ramsthaler F, Kettner M, Mall G. Diagnostics of messenger ribonucleic acid (mRNA) severe acute respiratory syndrome-corona virus‑2 (SARS-CoV‑2) vaccination-associated myocarditis—A systematic review. Rechtsmedizin (Berl) 2022; 33:125-131. [PMID: 35873498 PMCID: PMC9297279 DOI: 10.1007/s00194-022-00587-9] [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] [Accepted: 06/17/2022] [Indexed: 12/15/2022]
Abstract
Background Objective Methods Results Conclusion Supplementary Information
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Affiliation(s)
- Jan M. Federspiel
- Institute of Legal Medicine, Saarland University, Campus Homburg, Kirrbergerstraße, Geb. 49.1, 66421 Homburg Saar, Germany
| | - Frank Ramsthaler
- Institute of Legal Medicine, Saarland University, Campus Homburg, Kirrbergerstraße, Geb. 49.1, 66421 Homburg Saar, Germany
| | - Mattias Kettner
- Institute of Legal Medicine, Goethe University Frankfurt Main, Kennedyallee 104, 60596 Frankfurt Main, Germany
| | - Gerhard Mall
- Medical Care Center for Clinical Pathology, Grafenstraße 9, 64283 Darmstadt, Germany
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Hajjo R, Sabbah DA, Bardaweel SK, Tropsha A. Shedding the Light on Post-Vaccine Myocarditis and Pericarditis in COVID-19 and Non-COVID-19 Vaccine Recipients. Vaccines (Basel) 2021; 9:vaccines9101186. [PMID: 34696294 PMCID: PMC8541143 DOI: 10.3390/vaccines9101186] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 12/17/2022] Open
Abstract
Myocarditis and pericarditis have been linked recently to COVID-19 vaccines without exploring the underlying mechanisms, or compared to cardiac adverse events post-non-COVID-19 vaccines. We introduce an informatics approach to study post-vaccine adverse events on the systems biology level to aid the prioritization of effective preventive measures and mechanism-based pharmacotherapy by integrating the analysis of adverse event reports from the Vaccine Adverse Event Reporting System (VAERS) with systems biology methods. Our results indicated that post-vaccine myocarditis and pericarditis were associated most frequently with mRNA COVID-19 vaccines followed by live or live-attenuated non-COVID-19 vaccines such as smallpox and anthrax vaccines. The frequencies of cardiac adverse events were affected by vaccine, vaccine type, vaccine dose, sex, and age of the vaccinated individuals. Systems biology results suggested a central role of interferon-gamma (INF-gamma) in the biological processes leading to cardiac adverse events, by impacting MAPK and JAK-STAT signaling pathways. We suggest that increasing the time interval between vaccine doses minimizes the risks of developing inflammatory adverse reactions. We also propose glucocorticoids as preferred treatments based on system biology evidence. Our informatics workflow provides an invaluable tool to study post-vaccine adverse events on the systems biology level to suggest effective mechanism-based pharmacotherapy and/or suitable preventive measures.
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Affiliation(s)
- Rima Hajjo
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman 11733, Jordan;
- Laboratory for Molecular Modeling, Division of Chemical Biology and Medicinal Chemistry, Eshelman School of Pharmacy, The University of North Carlina at Chapel Hill, Chapel Hill, NC 27515, USA;
- National Center for Epidemics and Communicable Disease Control, Amman 11942, Jordan
- Correspondence:
| | - Dima A. Sabbah
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman 11733, Jordan;
| | - Sanaa K. Bardaweel
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Jordan, Amman 11942, Jordan;
| | - Alexander Tropsha
- Laboratory for Molecular Modeling, Division of Chemical Biology and Medicinal Chemistry, Eshelman School of Pharmacy, The University of North Carlina at Chapel Hill, Chapel Hill, NC 27515, USA;
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Yoshizawa H, Ikeda Y, Hatakeyama K, Yoshida KI. Myocardial ischemic injury derived from multiple thromboemboli due to eosinophilic endomyocarditis (Löffler endocarditis) causing right ventricular rupture. Pathol Int 2021; 71:722-724. [PMID: 34416077 DOI: 10.1111/pin.13152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/30/2021] [Accepted: 08/04/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Hidenori Yoshizawa
- Osaka Prefectural Medical Examiner's office, Osaka, Japan.,Department of Diagnostic Pathology, Osaka University Hospital, Osaka, Japan
| | - Yoshihiko Ikeda
- Department of Pathology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kinta Hatakeyama
- Department of Pathology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Ken-Ichi Yoshida
- Osaka Prefectural Medical Examiner's office, Osaka, Japan.,Department of Forensic Medicine, Tokyo Medical University, Tokyo, Japan
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Haybar H, Maleki Behzad M, Shahrabi S, Ansari N, Saki N. Expression of Blood Cells Associated CD Markers and Cardiovascular Diseases: Clinical Applications in Prognosis. Lab Med 2020; 51:122-142. [PMID: 31340048 DOI: 10.1093/labmed/lmz049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Cardiovascular diseases (CVDs) are a major cause of mortality worldwide. The results of various studies have shown that abnormality in the frequency and function of blood cells can be involved in CVD complications. In this review, we have focused on abnormalities in the expression of the CD (cluster of differentiation) markers of blood cells to assess the association of these abnormalities with CVD prognosis. METHODS We identified the relevant literature through a PubMed search (1990-2018) of English-language articles using the terms "Cardiovascular diseases", "CD markers", "leukocytes", "platelets", and "endothelial cells". RESULTS There is a variety of mechanisms for the effect of CD-marker expressions on CVDs prognosis, ranging from proinflammatory processes to dysfunctional effects in blood cells. CONCLUSION Considering the possible effects of CD-marker expression on CVDs prognosis, particularly prognosis of acute myocardial infarction and atherosclerosis, long-term studies in large cohorts are required to identify the prognostic value of CD markers and to target them with appropriate therapeutic agents.
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Affiliation(s)
- Habib Haybar
- Atherosclerosis Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Masumeh Maleki Behzad
- Thalassemia and Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Saeid Shahrabi
- Department of Biochemistry and Hematology, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Narges Ansari
- Isfahan Bone Metabolic Disorders Research Center, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Najmaldin Saki
- Thalassemia and Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Carranza-Rodríguez C, San-Román-Sánchez D, Marrero-Santiago H, Hernández-Cabrera M, Gil-Guillén C, Pisos-Álamo E, Jaén-Sánchez N, Pérez-Arellano JL. Endomyocardial involvement in asymptomatic sub-Saharan immigrants with helminth-related eosinophilia. PLoS Negl Trop Dis 2017; 11:e0005403. [PMID: 28234952 PMCID: PMC5342272 DOI: 10.1371/journal.pntd.0005403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 03/08/2017] [Accepted: 02/12/2017] [Indexed: 02/06/2023] Open
Abstract
Background Among immigrants of sub-Saharan origin, parasitic infection is the leading cause of eosinophilia, which is generally interpreted as a defense mechanism. A side effect of the inflammatory mediators released by eosinophils is damage to host organs, especially the heart. The main objectives of this study were to i) assess cardiac involvement in asymptomatic sub-Saharan immigrants with eosinophilia, ii) relate the presence of lesions with the degree of eosinophilia, and iii) study the relationship between cardiac involvement and the type of causative parasite. Methodology/Principle findings In total, the study included 50 black immigrants (37 patients and 13 controls) from sub-Saharan Africa. In all subjects, heart structure and function were evaluated in a blinded manner using Sonos 5500 echocardiographic equipment. The findings were classified and described according to established criteria. The diagnostic criteria for helminthosis were those reported in the literature. Serum eosinophil-derived neurotoxin levels were measured using enzyme-linked immunosorbent assay. A significant association was found between the presence of eosinophilia and structural alterations (mitral valve thickening). However, the lack of an association between the degree of eosinophilia and heart valve disease and the absence of valve involvement in some patients with eosinophilia suggest the role of other factors in the appearance of endocardial lesions. There was also no association between the type of helminth and valve involvement. Conclusions We, therefore, suggest that transthoracic echocardiography be performed in every sub-Saharan individual with eosinophilia in order to rule out early heart valve lesions. Endomyocardial fibrosis is characterized by fibrosis of the apical endocardium of the right ventricle, left ventricle, or both. Epidemiological studies of endomyocardial fibrosis indicate a predominance in tropical regions, with young people and men being affected predominantly. Little is known about the natural history and pathogenic factors of this condition. One of the most important factors is the presence of eosinophilia, which is mainly related to helminth infections. The aim of the study was to evaluate cardiac involvement in patients with absolute eosinophilia. We performed an echocardiographic study in asymptomatic sub-Saharan immigrants with eosinophilia and compared them with a group of control patients from the same region and of the same age. Our results suggest that eosinophilia associated with helminth infection (regardless of the causative microorganism) contributes to the asymptomatic phases of endomyocardial involvement. Treatment of these infections is simple, effective, and economical. Therefore, we suggest that all immigrant patients with eosinophilia undergo etiologic study and causal treatment as well as transthoracic echocardiography in order to rule out early damage.
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Affiliation(s)
- Cristina Carranza-Rodríguez
- Department of Medical and Surgery Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
- Infectious Diseases and Tropical Medicine Division, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
- * E-mail:
| | - Daniel San-Román-Sánchez
- Department of Medical and Surgery Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
- Cardiology Division, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Héctor Marrero-Santiago
- Cardiology Division, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Michele Hernández-Cabrera
- Department of Medical and Surgery Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
- Infectious Diseases and Tropical Medicine Division, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Carlos Gil-Guillén
- Cardiology Division, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Elena Pisos-Álamo
- Department of Medical and Surgery Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
- Infectious Diseases and Tropical Medicine Division, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - Nieves Jaén-Sánchez
- Department of Medical and Surgery Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
- Infectious Diseases and Tropical Medicine Division, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
| | - José-Luis Pérez-Arellano
- Department of Medical and Surgery Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
- Infectious Diseases and Tropical Medicine Division, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
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Bleakley C, McEneaney D. Eosinophilic myocarditis presenting as acute myocardial infarction. J Cardiovasc Med (Hagerstown) 2012; 12:761-4. [PMID: 20407381 DOI: 10.2459/jcm.0b013e32833758e7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Arsenovic N, Sheehan L, Clark D, Moreira R. Fatal carbamazepine induced fulminant eosinophilic (hypersensitivity) myocarditis: Emphasis on anatomical and histological characteristics, mechanisms and genetics of drug hypersensitivity and differential diagnosis. J Forensic Leg Med 2010; 17:57-61. [DOI: 10.1016/j.jflm.2009.07.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2009] [Revised: 07/07/2009] [Accepted: 07/19/2009] [Indexed: 11/25/2022]
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Sudden death due to eosinophilic endomyocardial diseases: three case reports. Am J Forensic Med Pathol 2009; 29:354-7. [PMID: 19259026 DOI: 10.1097/paf.0b013e3181859fe3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Eosinophils are associated with various disorders, such as allergic or hypersensitivity reactions, parasitic diseases, connective tissue diseases, certain neoplastic diseases (Hodgkin's disease, lymphomas, and carcinomas), and various immune deficiency states. Eosinophils can infiltrate any tissue and can cause tissue damage. Heart, has been demonstrated to be the most extensively involved and toxicity of eosinophils is well-established on cardiac tissue. We describe 3 cases with extensive eosinophilic infiltration without endomyocardial fibrosis. All patients died after a short clinical course with rapidly progressive heart failure. Bronchial asthma, hydatid disease and drug reaction were considered as possible etiologies of eosinophilia in case 1 and case 2. Case 3 was considered to fall into the "idiopathic hypereosinophilic syndrome" in which no underlying causes for eosinophilia could be identified.
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Affiliation(s)
- Navneet Narula
- University of California at Irvine Medical Center, Orange, CA 92868-4080, USA.
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Chikwava KR, Savell VH, Boyd TK. Fatal cephalosporin-induced acute hypersensitivity myocarditis. Pediatr Cardiol 2006; 27:777-80. [PMID: 17111287 DOI: 10.1007/s00246-006-1430-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2006] [Accepted: 08/03/2006] [Indexed: 10/23/2022]
Abstract
A frequently fatal, although rare, side effect of cephalosporin antibiotics is noninfectious myocarditis. We report two cases of hypersensitivity myocarditis secondary to administration of cephalosporin antibiotics. In both cases, acute hypersensitivity myocarditis was not suspected clinically, and the diagnosis was made postmortem. Histology revealed intense eosinophilic infiltration of the endomyocardium with eosinophil degranulation and myocyte damage, Clinically, death in both cases was due to cardiac failure. When suspected early, appropriate management may be lifesaving.
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Affiliation(s)
- Kudakwashe R Chikwava
- Department of Pathology, Children's Hospital of Pittsburgh, 3705 Fifth Avenue, Pittsburgh, PA 15213, USA
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