THE ROLE OF IMMUNITY SUPPRESSION IN TREATMENT OF MYOCARDITIS
Regardless the common consensus on the benefits of immunity suppression in eosinophilic, granulomatous, giant cell and lymphocyte myocarditis, associated with systemic connective tissue diseases, and in rejection of transplanted heart, role of immune suppression therapy (IST) in treatment of lymphoc...
| Main Authors: | , , |
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| Format: | Article |
| Language: | Russian |
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«FIRMA «SILICEA» LLC
2017-02-01
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| Series: | Российский кардиологический журнал |
| Subjects: | |
| Online Access: | https://russjcardiol.elpub.ru/jour/article/view/837 |
| _version_ | 1797856934614794240 |
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| author | A. Frustaci C. Cimenti G. G. Taradin |
| author_facet | A. Frustaci C. Cimenti G. G. Taradin |
| author_sort | A. Frustaci |
| collection | DOAJ |
| description | Regardless the common consensus on the benefits of immunity suppression in eosinophilic, granulomatous, giant cell and lymphocyte myocarditis, associated with systemic connective tissue diseases, and in rejection of transplanted heart, role of immune suppression therapy (IST) in treatment of lymphocyte inflammatory cardiomyopathy remains controversial. Previous retrospective studies revealed clinical improvement in 90% of patients with virus-negative inflammatory cardiomyopathy and absence of response or worsening of heart function in 85% of virus-positive inflammatory cardiomyopathy after immunity suppression. Other studies identified the enhanced expression of HLA in cardiomyocytes as an additional indicator of sensitivity of inflammatory cardiomyopathy to IST. Recently, the singlecenter randomized study was performed with double blind application of prednisone and azatioprin as addition to maintenance therapy in 85 patients with virus-negative inflammatory cardiomyopathy. The results of the study showed significant improvement of the left ventricle ejection fraction and decrease of the left ventricle dimensions in 88% patients among 43 of treated comparing to 42 patients on placebo demonstrated worsening of cardiac functioning in 83% cases (the TIMIC study).This data confirms the efficacy of immunity suppression in virus-negative inflammatory cardiomyopathy. Insufficiency of response in 12% cases undermines existence of non-revealed viruses and mechanisms of damage and inflammation, non-sensitive to immunity suppression. Restoring of cardiac function in patients actively responded to immunity suppression, was determined by inhibition of cardiomyocytes death and increase of cells proliferation with ad novo synthesized contractile material. |
| first_indexed | 2024-04-09T20:48:35Z |
| format | Article |
| id | doaj.art-327c073979674dac939a856b46a0db0b |
| institution | Directory Open Access Journal |
| issn | 1560-4071 2618-7620 |
| language | Russian |
| last_indexed | 2024-04-09T20:48:35Z |
| publishDate | 2017-02-01 |
| publisher | «FIRMA «SILICEA» LLC |
| record_format | Article |
| series | Российский кардиологический журнал |
| spelling | doaj.art-327c073979674dac939a856b46a0db0b2023-03-29T21:23:27Zrus«FIRMA «SILICEA» LLCРоссийский кардиологический журнал1560-40712618-76202017-02-010211411810.15829/1560-4071-2017-2-114-118786THE ROLE OF IMMUNITY SUPPRESSION IN TREATMENT OF MYOCARDITISA. Frustaci0C. Cimenti1G. G. Taradin2La Sapienza University, Rome; IRCCS L. Spallanzani, RomeLa Sapienza University, Rome; IRCCS L. Spallanzani, Rome; IRCCS San Raffaele La Pisana, RomeDonetsk National Medical University n.a. M. Gorky, Donetsk; V.K.Gusak Institute of Emergent and Reparative Surgery, DonetskRegardless the common consensus on the benefits of immunity suppression in eosinophilic, granulomatous, giant cell and lymphocyte myocarditis, associated with systemic connective tissue diseases, and in rejection of transplanted heart, role of immune suppression therapy (IST) in treatment of lymphocyte inflammatory cardiomyopathy remains controversial. Previous retrospective studies revealed clinical improvement in 90% of patients with virus-negative inflammatory cardiomyopathy and absence of response or worsening of heart function in 85% of virus-positive inflammatory cardiomyopathy after immunity suppression. Other studies identified the enhanced expression of HLA in cardiomyocytes as an additional indicator of sensitivity of inflammatory cardiomyopathy to IST. Recently, the singlecenter randomized study was performed with double blind application of prednisone and azatioprin as addition to maintenance therapy in 85 patients with virus-negative inflammatory cardiomyopathy. The results of the study showed significant improvement of the left ventricle ejection fraction and decrease of the left ventricle dimensions in 88% patients among 43 of treated comparing to 42 patients on placebo demonstrated worsening of cardiac functioning in 83% cases (the TIMIC study).This data confirms the efficacy of immunity suppression in virus-negative inflammatory cardiomyopathy. Insufficiency of response in 12% cases undermines existence of non-revealed viruses and mechanisms of damage and inflammation, non-sensitive to immunity suppression. Restoring of cardiac function in patients actively responded to immunity suppression, was determined by inhibition of cardiomyocytes death and increase of cells proliferation with ad novo synthesized contractile material.https://russjcardiol.elpub.ru/jour/article/view/837heart failureinflammatory cardiomyopathyimmunity suppression therapymyocarditistreatmentfunction restoringviruses |
| spellingShingle | A. Frustaci C. Cimenti G. G. Taradin THE ROLE OF IMMUNITY SUPPRESSION IN TREATMENT OF MYOCARDITIS Российский кардиологический журнал heart failure inflammatory cardiomyopathy immunity suppression therapy myocarditis treatment function restoring viruses |
| title | THE ROLE OF IMMUNITY SUPPRESSION IN TREATMENT OF MYOCARDITIS |
| title_full | THE ROLE OF IMMUNITY SUPPRESSION IN TREATMENT OF MYOCARDITIS |
| title_fullStr | THE ROLE OF IMMUNITY SUPPRESSION IN TREATMENT OF MYOCARDITIS |
| title_full_unstemmed | THE ROLE OF IMMUNITY SUPPRESSION IN TREATMENT OF MYOCARDITIS |
| title_short | THE ROLE OF IMMUNITY SUPPRESSION IN TREATMENT OF MYOCARDITIS |
| title_sort | role of immunity suppression in treatment of myocarditis |
| topic | heart failure inflammatory cardiomyopathy immunity suppression therapy myocarditis treatment function restoring viruses |
| url | https://russjcardiol.elpub.ru/jour/article/view/837 |
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