title: Up-regulation of ectopic trypsins in the myocardium by influenza A virus infection triggers acute myocarditis.
abstract: OBJECTIVE
  Influenza A virus (IAV) infection markedly up-regulates ectopic trypsins in various organs, viral envelope glycoprotein processing proteases, which are pre-requisites for virus entry and multiplication. We investigated the pathological roles of trypsin up-regulation in the progression of IAV-induced myocarditis, cytokine induction, and viral replication in the hearts, and also investigated the protective effects of trypsin inhibitor on cardiac dysfunction in vivo and selective knockdown of trypsin on IAV-induced cellular damage in cardiomyoblasts.
  
  
  RESULTS
  The relationship of the expression among IAV RNA, trypsins, matrix metalloproteinase (MMP)-9, MMP-2, pro-inflammatory cytokines interleukin (IL)-6, IL-1β, and tumour necrosis factor-α was analysed in mice hearts and cardiomyoblasts after IAV infection. The severity of myocarditis was most noticeable during Day 6-9 post-infection, along with peak expression of viral RNA, trypsins, particularly trypsin₂, MMPs, and cytokines. Cardiac ATP levels were the lowest at Day 9. Up-regulated trypsins, viral protein, and tissue-injured loci in the myocardium were closely localized. Trypsin inhibitor aprotinin treatment in vivo and selective trypsin₁- and trypsin₂-knockdown, particularly the latter, in H9c2 cardiomyoblasts significantly suppressed viral replication, up-regulation of MMPs, and production of active MMP-9 and cytokines, resulting in marked protection against cellular damage, ATP depletion, and apoptosis. IAV infection-induced cardiac dysfunction monitored by echocardiography was improved significantly by aprotinin treatment.
  
  
  CONCLUSIONS
  IAV-induced trypsins, particularly trypsin₂, in the myocardium trigger acute viral myocarditis through stimulation of IAV replication, proMMP-9 activation, and cytokine induction. These results suggest that up-regulation of trypsins is one of the key host pathological findings in IAV-induced myocarditis.
authors.affiliation: Division of Enzyme Chemistry, Institute for Enzyme Research, The University of Tokushima, Tokushima 770-8503, Japan.
authors.forename: Hai-Yan
authors.initials: HY
authors.lastname: Pan
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Yamada
authors.forename: Junji
authors.initials: J
authors.lastname: Chida
authors.forename: Siye
authors.initials: S
authors.lastname: Wang
authors.forename: Mihiro
authors.initials: M
authors.lastname: Yano
authors.forename: Min
authors.initials: M
authors.lastname: Yao
authors.forename: Jianhua
authors.initials: J
authors.lastname: Zhu
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kido
mesh_terms: D000208:Acute Disease; D000255:Adenosine Triphosphate / Q000378:metabolism; D000818:Animals; D000956:Antigens, Viral / Q000378:metabolism; D007611:Aprotinin / Q000494:pharmacology; D002460:Cell Line; D004195:Disease Models, Animal; D004487:Edema / Q000378:metabolism / Q000473:pathology / Q000821:virology; D009980:Influenza A virus / Q000254:growth & development*; D053583:Interleukin-1beta / Q000378:metabolism; D015850:Interleukin-6 / Q000378:metabolism; D008297:Male; D020778:Matrix Metalloproteinase 2 / Q000378:metabolism; D020780:Matrix Metalloproteinase 9 / Q000378:metabolism; D053078:Membrane Potential, Mitochondrial / Q000502:physiology; D051379:Mice; D008807:Mice, Inbred BALB C; D009205:Myocarditis / Q000378:metabolism / Q000473:pathology / Q000821:virology; D032383:Myocytes, Cardiac / Q000166:cytology / Q000201:enzymology / Q000821:virology; D009976:Orthomyxoviridae Infections / Q000378:metabolism* / Q000473:pathology; D014357:Trypsin / Q000235:genetics / Q000378:metabolism*; D014361:Trypsin Inhibitors / Q000494:pharmacology; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D015854:Up-Regulation / Q000502:physiology
chemical_list: D000956:Antigens, Viral; D053583:Interleukin-1beta; D015850:Interleukin-6; D014361:Trypsin Inhibitors; D014409:Tumor Necrosis Factor-alpha; D000255:Adenosine Triphosphate; D007611:Aprotinin; C549765:Prss1 protein, mouse; D014357:Trypsin; D020778:Matrix Metalloproteinase 2; C522362:Mmp2 protein, mouse; D020780:Matrix Metalloproteinase 9; C501830:Mmp9 protein, mouse