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Gupalo EM, Buryachkovskaya LI, Chumachenko PV, Mironova NA, Narusov OY, Tereschenko SN, Golitsyn SP, Othman M. Implication of Inflammation on Coxsackie Virus and Adenovirus Receptor Expression on Cardiomyocytes and the Role of Platelets in Patients with Dilated Cardiomyopathy. Cardiovasc Pathol 2022; 60:107452. [PMID: 35850451 DOI: 10.1016/j.carpath.2022.107452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 06/27/2022] [Accepted: 07/12/2022] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Coxsackie Virus and Adenovirus Receptor (CXADR or CAR) is involved in the pathogenesis of inflammatory dilated cardiomyopathy (DCM). We aimed to examine the relationship of CAR expression on platelets and cardiomyocytes with virus persistence, local and systemic inflammation and platelet activity in patients with DCM. METHODS Endomyocardial biopsy (EMB) samples of 38 patients (mean age 39.5±11.3 years, 20 male) with DCM were analyzed for CAR expression, local inflammation grade by immunohistochemistry and virus persistence by real-time PCR. Platelet morphology was analyzed in all patients and 30 healthy subjects (HS) using scanning electron microscopy, platelet activity by light transmission aggregation, and CAR persistence by immunofluorescence. Platelets of 20 patients were analyzed for cytomegalovirus and herpes simplex virus 1-2 by immunofluorescence. Serum levels of tumor necrosis factor alpha (TNF α) and Interleukin-6 were assessed using ELISA in all studied subjects. RESULTS CAR expression in EMB samples was related to the heart failure functional class and the level of IL-6. Platelets from DCM patients showed enhanced spontaneous and ADP induced aggregation. Platelets' CAR expression was >4 fold higher in DCM than HS and was observed predominantly at sites of intercellular communications in microaggregates and leukocyte-platelet aggregates. CAR-positive patients showed significantly higher TNF-α and IL-6 serum levels in CAR-negative patients. Platelets of 6 (30%) DCM patients revealed the mature cytomegalovirus and herpes simplex viruses particles. CONCLUSION Tight junction protein CAR may serve as a docking pin creating a new type of contact structure that could be responsible for signaling between neighboring cells in pathological conditions.
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Affiliation(s)
- Elena M Gupalo
- National Medical Research Center of Cardiology named after academician E.I. Chazov, Moscow, Russia.
| | | | - Petr V Chumachenko
- National Medical Research Center of Cardiology named after academician E.I. Chazov, Moscow, Russia
| | - Natalia A Mironova
- National Medical Research Center of Cardiology named after academician E.I. Chazov, Moscow, Russia
| | - Oleg Yu Narusov
- National Medical Research Center of Cardiology named after academician E.I. Chazov, Moscow, Russia
| | - Sergei N Tereschenko
- National Medical Research Center of Cardiology named after academician E.I. Chazov, Moscow, Russia
| | - Sergei P Golitsyn
- National Medical Research Center of Cardiology named after academician E.I. Chazov, Moscow, Russia
| | - Maha Othman
- Department of Biomedical and Molecular Sciences, School of Medicine, Queens's University, Kingston, ON, Canada; School of Baccalaureate Nursing, St. Lawrence College, Kingston, ON, Canada; Clinical Patology Department, Faculty of Medicine, Mansoura University, Egypt
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García-Becerril GE, Cruz-Montalvo AE, De La Cruz MA, Ares MA, Moreno-Ruiz LA, García-Chequer AJ, Maldonado-Bernal C, Gómez-Jiménez LM, Flores-García CA, Garrido-Garduño MH, Cárdenas-Mondragón MG. Differential expression of coxsackievirus and adenovirus receptor in endomyocardial tissue of patients with myocarditis. Mol Med Rep 2019; 20:2189-2198. [PMID: 31257515 PMCID: PMC6691199 DOI: 10.3892/mmr.2019.10444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 06/05/2019] [Indexed: 12/15/2022] Open
Abstract
Recent studies demonstrated that the expression of coxsackievirus and adenovirus receptor (CAR) is implicated in the pathophysiology of myocarditis. The aim of the present study was to assess the association between active and borderline myocarditis and CAR expression in endomyocardial tissues, and analyze the association between CAR expression and treatment response. An analytic, cross-sectional, retrospective study was performed in 26 patients with myocarditis and 10 control subjects without heart disease. Myocardial biopsies were obtained and CAR transcription was measured by reverse transcription-quantitative polymerase chain reaction analysis. The association between CAR mRNA levels and the response to immunosuppressive or conventional therapy (treatment responders, n=17; non-responders, n=9) or with the type of histological myocarditis (active myocarditis, n=16; borderline myocarditis, n=10) was analyzed. CAR transcription levels were significantly lower (P=0.012) in patients with myocarditis compared with controls, and a significant decrease was observed (P=0.023) in CAR mRNA levels among patients with borderline myocarditis compared with the no myocarditis group. Patients responding to therapy exhibited higher CAR mRNA levels (P=0.036) compared with patients not responding to treatment, as evaluated based on clinical and echocardiographic criteria (immunosuppressive therapy, n=8; conventional therapy, n=1). Myocarditis in non-responders was associated with fewer clinical manifestations and lower CAR mRNA levels. A significant difference was only found regarding the use of oral steroids in patients with active myocarditis who responded to treatment (P=0.02), with no difference in borderline myocarditis. In conclusion, the transcriptional level of CAR is low in the endomyocardial tissue of patients with myocarditis, and it is lower in borderline myocarditis and in non-responder patients. These findings may enable early identification of patients who may benefit from treatment and timely determination of prognosis.
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Affiliation(s)
- Gustavo E García-Becerril
- Clínica de Insuficiencia Cardiaca, UMAE Hospital de Cardiología del Centro Médico Nacional Siglo‑XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico
| | - Aníbal E Cruz-Montalvo
- Unidad de Cuidados Intensivos Cardiovasculares, UMAE Hospital de Cardiología del Centro Médico Nacional Siglo‑XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico
| | - Miguel A De La Cruz
- Unidad de Investigación Médica en Enfermedades Infecciosas y Parasitarias, UMAE Hospital de Pediatría 'Dr. Silvestre Frenk Freund', Centro Médico Nacional Siglo‑XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico
| | - Miguel A Ares
- Unidad de Investigación Médica en Enfermedades Infecciosas y Parasitarias, UMAE Hospital de Pediatría 'Dr. Silvestre Frenk Freund', Centro Médico Nacional Siglo‑XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico
| | - Luis A Moreno-Ruiz
- Servicio de Hospitalización Adultos, UMAE Hospital de Cardiología del Centro Médico Nacional Siglo‑XXI, IMSS, Mexico City 06720, Mexico
| | - Adda J García-Chequer
- Laboratorio en Biología del Desarrollo, Unidad de Hemato‑Oncología e Investigación del Hospital Infantil de México, 'Federico Gómez', Secretaria de Salud, Mexico City 06720, Mexico
| | - Carmen Maldonado-Bernal
- Laboratorio de Investigación en Inmunología y Proteómica, Hospital Infantil de México, 'Federico Gómez', Secretaria de Salud, Mexico City 06720, Mexico
| | - Luz M Gómez-Jiménez
- Servicio de Patología UMAE Hospital de Especialidades del Centro Médico Nacional Siglo‑XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico
| | - Cesar A Flores-García
- Servicio de Patología, UMAE Hospital de Cardiología del Centro Médico Nacional Siglo‑XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico
| | - Martín H Garrido-Garduño
- Clínica de Insuficiencia Cardiaca, UMAE Hospital de Cardiología del Centro Médico Nacional Siglo‑XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico
| | - María G Cárdenas-Mondragón
- Unidad de Investigación Médica en Enfermedades Infecciosas y Parasitarias, UMAE Hospital de Pediatría 'Dr. Silvestre Frenk Freund', Centro Médico Nacional Siglo‑XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico
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Abstract
At present, virus infection is still a common threat to public health in developing countries. Human rabies remains a matter of great global concern with a case-fatality of almost 100%. The rabies virus belongs to the neurotropic type of virus of the Lyssavirus genus, and the disease presents as a deteriorating encephalomyelitis and is endemic throughout much of the world, particularly in Africa and Asia. Previous data have shown that, globally, approximately 59 000 human deaths are caused by rabies per year. Fortunately, human rabies can be treated through the timely administration of post-exposure prophylaxis (PEP). These days immunization using the rabies vaccine has become standard practice for individuals who have suffered bites or scratches from an animal, or who have been exposed to the body fluids of an infected animal. However, we have recently encountered a case of human rabies which arose through a rare transmission method, and we believe that lessons can and should be learnt from this incident.
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Affiliation(s)
- Jian-yong Zhu
- Department of Emergency Medicine, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Jian Pan
- Department of Emergency Medicine, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Yuan-qiang Lu
- Department of Emergency Medicine, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
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Role of coxsackievirus and adenovirus receptor (CAR) expression and viral load of adenovirus and enterovirus in patients with dilated cardiomyopathy. Arch Virol 2015; 161:87-94. [PMID: 26483283 DOI: 10.1007/s00705-015-2632-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Accepted: 09/26/2015] [Indexed: 12/21/2022]
Abstract
Enteroviruses (EVs) and adenoviruses (AdVs) are two important etiological agents of viral myocarditis and dilated cardiomyopathy (DCM). Both these viruses share a common receptor, the coxsackievirus and adenovirus receptor (CAR), for their infection. However, the role of viral load and CAR expression in disease severity has not yet been completely elucidated. The present study aimed to determine viral load of EV and AdV in DCM patients and correlate them with the level of CAR expression in these patients. Sixty-three DCM cases and 30 controls, each of whom died of heart disease other than DCM and non-cardiac disease respectively, were included. Viral load was determined by TaqMan real-time PCR using primers and probes specific for the AdV hexon gene and the 5'UTR region of EV. The CAR mRNA level was semi-quantitated by RT-PCR, and antigen expression was studied by immunohistochemistry. A significantly high AdV load (p < 0.05) and CAR expression (p < 0.05) were observed in DCM cases versus controls, whereas the EV load showed no significant difference. The data suggests a clinical threshold of 128 AdV copies/500 ng of DNA for DCM, with 66.7 % sensitivity and 65 % specificity. A positive correlation between AdV load and CAR expression (p < 0.001) was also observed in DCM cases. The high adenoviral load and increased CAR expression in DCM and their association with adverse disease outcome indicates role of both virus and receptor in disease pathogenesis. Thus, the need for targeting both the virus and the receptor for treatment of viral myocarditis and early DCM requires further confirmation with larger studies.
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