Abstract
Acute myocarditis is a major inflammatory heart disease with a variety of clinical courses from the acute to chronic phases represented by unexpected circulatory deterioration during hospitalization and progression to dilated cardiomyopathy. Predicting these disease courses is important for patient management. However, biomarkers have not been fully investigated. In addition, clinical profiles including symptoms, serological data, and electrocardiographic findings in acute myocarditis often mimic more common disorders such as coronary artery disease, which have reduced the diagnostic accuracy of acute myocarditis. These issues hamper the development of safer and earlier therapeutic interventions specific for acute myocarditis. Against this background, identifying simple prognostic and diagnostic biomarkers would contribute dramatically to the improvement in outcomes. Interleukin-10 may be a strong candidate for an excellent biomarker.
Zusammenfassung
Die akute Myokarditis ist eine schwere inflammatorische Herzerkrankung. Ihr klinischer Verlauf ist variabel, er reicht von akuten bis zu chronischen Phasen, in denen es während der Hospitalisierung zu unerwarteten Verschlechterungen der Herz-Kreislauf-Situation kommt und zum Progress in eine dilatative Kardiomyopathie. Den Verlauf der Erkrankung zu prognostizieren ist wichtig für das Patientenmanagement. Doch Biomarker sind noch nicht vollständig erforscht. Zudem können klinische Profile (u. a. Symptome, serologische und elektrokardiographische Befunde) bei der akuten Myokarditis häufiger auftretende Störungen imitieren (z. B. eine koronare Herzerkrankung), daher ist die diagnostische Treffsicherheit verringert. Diese Aspekte machen die Entwicklung von sichereren und früher einzusetzenden therapeutischen Interventionen bei akuter Myokarditis problematisch. Daher würde die Identifikation von einfachen prognostischen und diagnostischen Biomarkern in hohem Maße zur Verbesserung des Outcome beitragen; Interleukin-10 scheint ein viel versprechender Kandidat zu sein.
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Abbreviations
- CRP:
-
C-reactive protein
- IFN:
-
Interferon
- IL:
-
Interleukin
- TNF:
-
Tumor necrosis factor
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Acknowledgments
This study was supported by a Grant-in-Aid for Scientific Research from the Postgraduate Research Project at Kitasato University and a Grant for Scientific Research from the Ministry of Education, Science and Culture of Japan (No. 20311954). The authors thank Guy Harris for restyling the manuscript. We thank Robert E. Brandt, Founder, CEO, and CME, MedEd Japan, for editing the manuscript.
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On behalf of all authors, the corresponding author states that there are no conflicts of interest.
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Izumi, T., Nishii, M. Diagnostic and prognostic biomarkers in acute myocarditis. Herz 37, 627–631 (2012). https://doi.org/10.1007/s00059-012-3661-6
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DOI: https://doi.org/10.1007/s00059-012-3661-6