Columbia Center for Translational Immunology, Columbia University College of Physicians and Surgeons, New York, NY, USA.
Department of Pneumology, University Hospital Krems, Karl Landsteiner University of Health Sciences, Krems, Austria.
Curr Cardiol Rep. 2020 Mar 20;22(5):28. doi: 10.1007/s11886-020-01278-1.
Over the last decade, myocarditis has been increasingly recognized as common cause of sudden cardiac death in young adults and heart failure overall. The purpose of this review is to discuss hypothesis of development of non-infectious myocarditis, to provide a description of the immunopathogenesis and the most common mechanisms of autoimmunity in myocarditis, and to provide an update on therapeutic options.
A new entity of myocarditis is immune checkpoint inhibitor (ICI) induced myocarditis. ICIs are used in advanced cancer to "disinhibit" the immune system and make it more aggressive in fighting cancer. This novel drug class has doubled life expectancy in metastatic melanoma and significantly increased progression free survival in advanced non-small-cell lung cancer, but comes with a risk of autoimmune diseases such as myocarditis resulting from an overly aggressive immune system. Myocarditis is an inflammatory disease of the heart with major public health impact. Thorough understanding of its immunopathogenesis is crucial for accurate diagnosis and effective treatment.
在过去十年中，心肌炎已被越来越多地认为是年轻人心源性猝死和心力衰竭的常见原因。本文的目的是讨论非传染性心肌炎的发病假说，描述心肌炎的免疫发病机制和最常见的自身免疫机制，并更新治疗选择。
一种新的心肌炎实体是免疫检查点抑制剂（ICI）诱导的心肌炎。ICI 用于晚期癌症中“抑制”免疫系统，使其更具攻击性以对抗癌症。这种新型药物类别使转移性黑色素瘤的预期寿命增加了一倍，并显著提高了晚期非小细胞肺癌的无进展生存期，但也带来了自身免疫性疾病的风险，如心肌炎，这是由于免疫系统过于活跃。心肌炎是一种影响心脏的炎症性疾病，对公共健康有重大影响。深入了解其免疫发病机制对于准确诊断和有效治疗至关重要。
