To systematically review the role of Toll-like receptors (TLRs) in infectious myocarditis, focusing on pathogen recognition and regulatory mechanisms.
Approach:
Epidemiological Overview: Summarizes the epidemiological characteristics of infectious myocarditis, including changes in pathogen spectrum.
TLR Functionality: Analyzes the expression patterns and signaling features of TLRs in the cardiac immune environment.
Pathogen Recognition: Examines recognition modes mediated by common pathogens.
Dynamic Regulation: Discusses regulatory rules of TLR signaling across different stages of myocarditis.
Intervention Strategies: Summarizes intervention strategies and translational challenges.
Key Findings:
COVID-19-associated myocarditis has a higher in-hospital mortality rate (19.4%) compared to influenza-associated myocarditis (10.5%).
Adeno-associated virus (AAV) gene therapy-related myocarditis has an incidence of 6.2%.
Sepsis-associated myocarditis exhibits a mortality rate of 70%-90%.
Pathogen-TLR matching influences inflammatory phenotypes and severity of infectious myocarditis.
The dynamics of TLR signaling are crucial in governing disease progression.
Interpretation:
The review emphasizes the need for a comprehensive understanding of TLR dynamics and pathogen specificity in developing targeted therapies for infectious myocarditis.
Limitations:
Current studies primarily focus on linear correlations between individual TLR activation and myocardial inflammation.
Limited exploration of TLR subtype matching and spatiotemporal dynamics in disease progression.
Conclusion:
This review provides a theoretical basis for immunodiagnosis and immunotherapy of infectious myocarditis.
A regional UK audit found wide variation in imaging intervals among patients referred for mechanical thrombectomy and identified potentially modifiable barriers to timely vascular imaging.
