Abstract
Understanding the meaning of parvovirus B19 (PB19V) in an etiology of dilated cardiomyopathy (DCM) is difficult. Viruses change the dynamics of the mitochondria by interfering with the mitochondrial process/function, causing the alteration of mitochondrial morphology. In this study, the ultrastructural changes in the mitochondria in endomyocardial biopsy (EMB) samples from patients with DCM and PB19V were determined. Methods: The PB19V evaluation was performed in EMB specimens by real-time PCR in 20 patients (age: 28 ± 6 years). The biopsy specimens were examined by histo- and immunohistochemistry to detect the inflammatory response. The ultrastructural features of the mitochondria were evaluated by electron microscopy. Results: The presence of PB19V in the heart tissue without the presence of inflammatory process, defined according to Dallas and immunohistochemical criteria, was associated with ultrastructural changes in the mitochondria. Distinctive ultrastructural pathologies were indicated, such as the presence of mitochondria in the vicinity of the expanded sarcoplasmic reticulum with amorphous material, blurred structure of mitochondria, interrupted outer mitochondrial membrane and mitophagy. Conclusions: Extending diagnostics with ultrastructural analysis of biopsy samples provides new knowledge of the changes associated with the presence of PB19V in the heart tissue. The observed changes can be a basis for searching for the damage mechanisms, as well as for new therapeutic solutions.
Highlights
IntroductionIn 50% of cases, dilated cardiomyopathy (DCM) is associated with the presence of a virus in the heart tissue [1,2]
Licensee MDPI, Basel, Switzerland.In 50% of cases, dilated cardiomyopathy (DCM) is associated with the presence of a virus in the heart tissue [1,2]
The study population included three groups: 10 patients with DCM and the confirmed presence of PB19V DNA in the myocardial tissue, 10 patients with DCM and without PB19V, and a control group consisting of 7 patients, who were eligible for suspected myocarditis but endomyocardial biopsy (EMB) did not confirm either tissue inflammation or PB19V in the heart tissue
Summary
In 50% of cases, dilated cardiomyopathy (DCM) is associated with the presence of a virus in the heart tissue [1,2]. In Europe, parvovirus B19 (B19V) is most commonly detected in the heart tissue [3,4]. Resulting in increased production of viral progeny. Viruses generate cellular stress, which causes mitochondrial redistribution. PB19V, as fast-replicating viruses, cope with cellular metabolic dysfunction [5]. The influence of fast-replicating viruses on the mitochondria results in modifications of the morphology, number, and localization of these organelles. The morphology of the mitochondria can be modified by the uncontrolled release of reactive oxygen species (ROS), which cause changes in the structure of cellular lipids and proteins by promoting the damage of the mitochondrial membranes’
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