Emerging treatments for viral myocarditis.
Although viral myocarditis has been mostly attributed to enterovirus and adenovirus infection, the importance of hepatitis C virus has recently been noted. Clinical trials of antiviral agents, such as interferons, are in progress, while new therapies such as viral vaccines, recombinant virus and virus receptors, are in preclinical development.Whereas immunosuppression with corticosteroids or cyclosporin is ineffective, immunosuppressors that do not promote viral replication, such as FTY720, and immunomodulation by interleukin-10, are promising new approaches. Inhibition of nuclear factor-kappaB, angiotensin II and endothelin effectively suppresses inflammation in experimental viral myocarditis. Embryonic stem cell therapy has been demonstrated to be beneficial; however, this requires further investigation.
Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, 54 Kawahara-cho Shogoin, Sakyo-ku, Kyoto 606-8507, Japan. amat@kuhp.kyoto-u.ac.jp
Akira
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Matsumori