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病毒性心肌炎:从分子机制到治疗前景。

Viral myocarditis: From molecular mechanisms to therapeutic prospects.

机构信息

Department of Chinese Materia Medica and Natural Medicines, School of Pharmacy, Air Force Medical University, Xi'an, Shaanxi, 710032, China; Key Laboratory of Gastrointestinal Pharmacology of Chinese Materia Medica of the State Administration of Traditional Chinese Medicine, Department of Pharmacology, School of Pharmacy, Air Force Medical University, Xi'an, Shaanxi, 710032, China.

Key Laboratory of Gastrointestinal Pharmacology of Chinese Materia Medica of the State Administration of Traditional Chinese Medicine, Department of Pharmacology, School of Pharmacy, Air Force Medical University, Xi'an, Shaanxi, 710032, China.

出版信息

Eur J Pharmacol. 2024 Nov 5;982:176935. doi: 10.1016/j.ejphar.2024.176935. Epub 2024 Aug 23.

DOI:10.1016/j.ejphar.2024.176935
PMID:39182550
Abstract

Myocarditis is characterized as local or diffuse inflammatory lesions in the myocardium, primarily caused by viruses and other infections. It is a common cause of sudden cardiac death and dilated cardiomyopathy. In recent years, the global prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the widespread vaccination have coincided with a notable increase in the number of reported cases of myocarditis. In light of the potential threat that myocarditis poses to global public health, numerous studies have sought to elucidate the pathogenesis of this condition. However, despite these efforts, effective treatment strategies remain elusive. To collate the current research advances in myocarditis, and thereby provide possible directions for further research, this review summarizes the mechanisms involved in viral invasion of the organism and primarily focuses on how viruses trigger excessive inflammatory responses and in result in different types of cell death. Furthermore, this article outlines existing therapeutic approaches and potential therapeutic targets for the acute phase of myocarditis. In particular, immunomodulatory treatments are emphasized and suggested as the most extensively studied and clinically promising therapeutic options.

摘要

心肌炎的特征为心肌局部或弥漫性炎症病变,主要由病毒等感染引起。它是导致心源性猝死和扩张型心肌病的常见原因。近年来,严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 的全球流行和广泛接种疫苗与报告的心肌炎病例数量显著增加同时发生。鉴于心肌炎对全球公共健康构成的潜在威胁,许多研究都试图阐明这种疾病的发病机制。然而,尽管做出了这些努力,仍然难以找到有效的治疗策略。为了整理心肌炎的当前研究进展,并为进一步研究提供可能的方向,本综述总结了病毒入侵机体的机制,并主要关注病毒如何引发过度的炎症反应,进而导致不同类型的细胞死亡。此外,本文概述了心肌炎急性期现有的治疗方法和潜在的治疗靶点。特别强调了免疫调节治疗,并将其作为研究最广泛、最有临床应用前景的治疗选择。

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引用本文的文献

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Eosinophilic myocarditis in dilated cardiomyopathy: a case report.扩张型心肌病中的嗜酸性粒细胞性心肌炎:一例报告
BMC Cardiovasc Disord. 2025 May 8;25(1):355. doi: 10.1186/s12872-025-04826-1.
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Fulminant parvovirus B19 myocarditis in infants -report of three post-pandemic cases.婴儿暴发性细小病毒B19心肌炎——三例大流行后病例报告
Eur J Clin Microbiol Infect Dis. 2025 May;44(5):1239-1243. doi: 10.1007/s10096-025-05072-1. Epub 2025 Feb 17.