Heart failure & cardiomyopathiesResearch article
Programmed Cell Death-1/Programmed Cell Death-Ligand 1 Pathway in High-Risk Lymphocytic Acute Myocarditis
- study
Authors' conclusion
PD-L1 is overexpressed in cardiomyocytes of patients with LAM compared with non-Infl-CMP or focal non-lymphocytic myocarditis, such as CS, suggesting that cardiac PD-L1 expression is likely a response to T-cell-mediated injury. PD-1 expression is blunted in infiltrating inflammatory cells in LAM compared with ACR, suggesting a disruption of the PD-L1/PD-1 axis in LAM.
Study context
- Population
- Patients with cardiac histology: high-risk lymphocytic acute myocarditis (lymphocytic AM (LAM)), cardiac sarcoidosis (CS), non-inflammatory cardiomyopathy, immune checkpoint inhibitor (ICI)-associated acute myocarditis, and heart transplant recipients with or without acute cellular rejection (ACR)patients with cardiac histology · LAM 39 · CS 26 · non-InflCMP 11 · ICI-AM 8 · ACR of grade ≥2R 28 · no ACR 30
- Participants
- 142 patients
- Comparison
- cardiac levels of PD-L1/PD-1 in patients with high-risk LAM, compared with cardiac sarcoidosis (CS), non-inflammatory cardiomyopathy (non-Infl CMP), ICI-AM, and acute cellular rejection (ACR)
- LAMn = 39
- CSn = 26
- non-InflCMPn = 11
- ICI-AMn = 8
- ACR ≥2Rn = 28
- no ACRn = 30
Main finding
As reported in the abstract
LAM
2
median · first to third quartile 2–3
CS
1
median · first to third quartile 1–2
non-InflCMP
0
median · first to third quartile 0–0
- Increased PD-L1 in LAM compared with CS or non-Infl-CMP
- P < 0.0001
Further findings
PD-L1 expression, ACR ≥2R vs no ACR
- PD-L1 expression higher in ACR ≥2R vs no ACR
PD-1 expression, LAM vs ACR ≥2R
- PD-1 blunted in LAM compared to ACR ≥2R
PD-L1 and PD-1 expression, LAM vs ICI-AM
- Similar cardiac PD-L1 expression but reduced cardiac PD-1 expression in LAM compared with ICI-AM
Original publication
Summarised from the published abstract; every number is checked against it