Dendritic cells and autoimmune heart failure.

Dilated cardiomyopathy is the most common cause of heart failure in young patients and often results from autoimmunity triggered by viral or bacterial infections. Dendritic cells are professional antigen-presenting cells residing in lymphatic tissue and in the heart. They are involved in both, host defense and maintenance of peripheral tolerance. Animal models suggest an important role for dendritic cells in the induction of autoimmune myocarditis. Activated and self-antigen loaded dendritic cells, for example, induce myocarditis and heart failure in susceptible mice. It appears that the combined presence of tissue damage and innate activation exceeding a certain threshold prompts dendritic cells to prime and amplify potentially autoreactive T cells targeting the heart. The concept of dendritic cell induced myocarditis helps us to understand disease pathogenesis and offers a nice approach to develop novel therapeutic strategies against a devastating heart disease.