Short-term prognostic value of initial serum levels of interleukin-10 in patients with acute myocarditis.
ABSTRACT The disease course of acute myocarditis has a wide spectrum and the predictors of the prognosis in patients with acute myocarditis have not yet been established. In the pathogenesis of myocarditis, the cytokine environment is important. In this study, we examined the predictive values of serum levels of interleukin-10 (IL-10) and IL-12 in the short-term prognosis of patients with acute myocarditis. Twenty-four consecutive patients who had been diagnosed as having acute active myocarditis were analyzed and monitored for 2 months. The patients with myocarditis were divided into the survival group (n=16) and the non-survival group (n=8). Initial serum levels of IL-10 (P=0.0015) and IL-12 (P=0.012) in the non-survival group were significantly higher than those of the survival group, and there was a significant correlation between IL-10 and IL-12 levels (P<0.0001). The univariate analyses showed that increased serum levels of IL-10 (hazard ratio 1.041, P=0.0004) and IL-12 (hazard ratio 1.128, P=0.0346) were significant predictors of mortality. In the Kaplan-Meier analysis, high levels of IL-10 (>or=7.0 pg/ml) (P=0.0239) strongly predicted high mortality. In conclusion, the elevation in serum IL-10 levels at the initial phase appeared to predict poor short-term prognosis in patients with acute myocarditis.
Article: Future therapeutic strategies in inflammatory cardiomyopathy: insights from the experimental autoimmune myocarditis model.[show abstract] [hide abstract]
ABSTRACT: Inflammatory cardiomyopathy is a common cause of heart failure developing on a basis of cardiac inflammation. Cardiac inflammation - or myocarditis - is usually triggered by infections or cardiac damage of any cause. Experimental autoimmune myocarditis refers to a CD4(+) T cell-mediated mouse model of inflammatory cardiomyopathy. So far, the experimental autoimmune myocarditis model helped us to understand the role of various chemokines, cytokines, and cell subsets in the progression of inflammatory heart disease. Here, we review the current therapeutic options for inflammatory cardiomyopathy, and delineate potential future treatment approaches from the most recent mechanistic insights given by the experimental autoimmune myocarditis model.Cardiovascular & hematological disorders drug targets. 01/2009; 8(4):313-21.
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ABSTRACT: Throughout the history of cardiology, physicians have attempted to treat cardiac inflammatory diseases in a multitude of different ways. In recent years, three major developments have confirmed the important role of anti-inflammatory drugs in cardiology: the development of new, more powerful drugs, the advent of evidence-based medicine, and the decline of rheumatic disease in western countries. Thus, we aim to review the indications for anti-inflammatory drugs in pericarditis and myocarditis. The management of pericarditis has been improved following the publication of the European guidelines in 2004. Indeed, recent randomized controlled trials highlighted the role of colchicine to i) prevent and treat recurrences of acute pericarditis and ii) prevent post pericardiectomy syndrome and its complications. With regard to the management of myocarditis, significant advances have been made towards furthering the understanding of the mechanisms involved, and in the identification of its underlying causes (especially viral vs. autoimmune). In addition, cardiac MRI and endomyocardial biopsy are now used to detect rare etiologies of myocarditis, which may benefit from immunosuppressive therapy (giant cell and eosinophilic myocarditis, cardiac sarcoidosis). Although broad consensus has yet to be reached regarding the management of acute myocarditis, identifying viral vs. autoimmune myocarditis allows a tailored treatment using antiviral or immunosuppressive drugs.Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry (Formerly Cu rrent Medicinal Chemistry - Anti-Inflammatory and Anti-Allergy Agents) 12/2012;