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Virus Linked To Causing Enlarged Hearts In Children With Certain Genetic Makeup

DALLAS, Texas, Aug. 25 -- A certain virus may make the body turn against itself in some children, leading to development of an enlarged heart, say scientists in today's Circulation: Journal of the American Heart Association.

Although researchers already know that inflammation can lead to idiopathic (cause unknown) dilated cardiomyopathy -- a condition in which the heart becomes enlarged and functions poorly -- there has been uncertainty about the mechanism by which the specific virus causes this sometimes fatal disease.

In a study of three children who developed myocarditis -- a heart disease triggered by infection, which precedes cardiomyopathy -- researchers found evidence that the immune system was responding in an unusually aggressive way to certain proteins called antigens. Antigens are located in viruses, and they trigger the cells in the body's immune system to respond.

The children's genetic background made them more susceptible to this virus, which led to an overreaction of the normal immune system response, making a relatively common virus -- coxsackievirus B (CVB) -- potentially deadly.

"There are many different variants of this virus and most all children are exposed to it, but they all don't develop myocarditis," says the study's senior author, Massimo Trucco, M.D., director, division of immunogenetics, Children's Hospital of Pittsburgh and professor of pediatrics of the University of Pittsburgh School of Medicine. "Fortunately, only some of these variants have certain genetic sequences that direct the virus to the target organ, in this case, the heart."

Among the various viruses, some may have a genetic sequence, which turns regular antigens into "super" antigens, powerful enough to trigger a more aggressive immune response. In the children studied, a superantigen led in part to the powerful response triggering the development of an enlarged heart. Once this form of CVB invades the body, it can cause the immune system to overreac
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Contact: Brian Henry
brianh@heart.org
(214) 706-1135
American Heart Association
24-Aug-1998


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