Cytokines that regulate autoimmune myocarditis.

A growing body of evidence suggests that autoimmune responses are involved in the pathogenesis of myocarditis and postinfectious cardiomyopathy. Autoimmunity may also arise after ischaemic or traumatic damage to heart tissue. Myocarditis leading to heart failure can be mimicked in rodents by immunisation with cardiac alpha myosin and peptides derived from it. Cytokines and chemokines, produced mainly by T-cells and antigen-presenting cells, control immune responses by acting as either potentiating or inhibitory agents. Gene targeting and experiments with antibodies and/or antagonists blocking cytokines and their receptors have uncovered mechanisms whereby such regulatory molecules are involved in the pathogenesis of myocarditis. Identification of regulatory key cytokines and the associated pro- or anti-inflammatory pathways involved in the pathogenesis of cardiac inflammation may have important implications for therapeutic strategies and vaccine design in the future.