A team of researchers in Berlin found that not all cardiac inflammation is equal. Their groundbreaking research reveals obvious cellular and molecular characteristics in heart tissue, depending on whether inflammation is caused by COVID-19, 199, vaccination, or other causes.
The results published this week in the Natural Cardiovascular Research could change how doctors treat myocarditis-inflammation of the myocarditis, which, if not treated, can lead to serious complications.
“We found a clear difference in immune activation,” said Dr. Henrike Maatz of the Max Delbrück Centre co-led in Berlin. “This knowledge may help develop new and more personalized therapies targeting specific types of inflammation.”
The team examined small heart tissue samples from patients with three different types of myocarditis: patients who recovered from COVID-19 but showed persistent heart symptoms, patients who developed cardiac inflammation after receiving the mRNA Covid-19 vaccine, and patients who were non-rotating- Myocarditis related to pre-pandemic.
Different reasons, different cell characteristics
Using advanced genetic sequencing techniques, scientists have created detailed maps of cells present in inflamed heart tissue. They found that although all three diseases involve inflammation, the specific immune cells that drive the process vary widely.
In post-hybrid patients, the researchers found that CD8+ T cells were more aggressive than other forms of myocarditis. They also identified unique populations of T cells that were previously observed only in the blood of patients with severe viruses.
In contrast, heart tissue in patients with myocarditis after vaccination showed a higher proportion of CD4+ T cells, overall mild and inflammation. This is consistent with clinical observations that most vaccine-related myocarditis cases tend to be quickly resolved with minimal intervention.
“This difference was unexpected,” said Dr. Eric Lindberg, co-leader of the paper.
Pandemic research opportunities
This research stems from a unique opportunity of the pandemic. Scientists at the Max Delbrück Center collaborated with cardiologists at Charité -carlité -Universitätsmedizin Berlin, who have been collecting tissue samples from patients with suspicious myocarditis.
“On DHZC we have a widely recognized myocarditis unit that specializes in endometrial biopsy in selected conditions.” Professor Carsten Tschöpe and Deutsal Zentrum Zentrum fiul fiul serz-ful serz- serz — Forschung (DZHK).
The study shows that post-hybrid myocarditis triggers a stronger immune response than other forms, which may explain why some recovering Covid patients continue to develop heart symptoms after several months of infection.
Molecular differences provide therapeutic clues
The researchers identified specific molecular patterns unique to each form of myocarditis. In the post-spinning cases, they observed an elevated interferon-γ expression, a signaling molecule that amplifies inflammation. At the same time, vaccine-related cases showed an increase in interleukin-16 and interleukin-18 levels.
These unique molecular characteristics suggest that each form of myocarditis may require different treatments. Current treatments usually involve general anti-inflammatory drugs, but the study suggests the potential for more targeted therapies.
“The ability to distinguish between inflammation caused by different types of infection and vaccination paves the way for improving treatment for specific types of inflammation,” Maatz explained.
Technology victory with small organizations
One of the most impressive aspects of this study is the ability of scientists to extract detailed genetic information from incredibly small tissue samples. Cardiac biopsy samples are usually no larger than Pinhead, so genetic analysis is extremely challenging.
“The resolution and depth we are able to produce really show the power of this approach – perhaps in the diagnostic environment in the future,” Maatz noted.
Professors Norbert Hübner of Charité, corresponding authors, emphasized that although the sample size of patients with myocarditis after vaccination is small, the results are consistent with other studies on vaccine-related cardiac inflammation.
These findings are crucial as global health systems continue to manage the long-term health impact of Covid-19. As millions of people are affected by the virus and billions are vaccinated, understanding the exact mechanisms of cardiac inflammation can help doctors better identify and treat patients at risk of heart complications.
As researchers continue to analyze the data, the study highlights the importance of precise medical methods, even if they produce similar symptoms, even if they produce unique characteristics of different disease processes.
“We are very grateful for the trust and valuable contribution of the patients,” Tschöpe said, acknowledging that the tissue sample made the study possible by people.
This study is part of a DZHK-supported anthropomorphism program that employs a comprehensive approach to studying myocarditis through targeted clinical and scientific assessments.
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