New Insights into Pericarditis: Mechanisms of Injury and Therapeutic Targets

Bo Xu, Serge C. Harb, Paul C. Cremer*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

22 Scopus citations

Abstract

Purpose of Review: This review article aims to provide a contemporary insight into the pathophysiological mechanisms of and therapeutic targets for pericarditis, drawing distinction between autoinflammatory and autoimmune pericarditis. Recent Findings: Recent research has focused on the distinction between autoinflammatory and autoimmune pericarditis. In autoinflammatory pericarditis, viruses can activate the sensor molecule of the inflammasome, which results in downstream release of cytokines, such as interleukin-1, that recruit neutrophils and macrophages to the site of injury. Conversely, in autoimmune pericarditis, a type I interferon signature predominates, and pericardial manifestations coincide with the severity of the underlying systemic autoimmune disease. In addition, autoimmune pericarditis can also develop after cardiac injury syndromes. With either type of pericarditis, imaging can help stage the inflammatory state. Prominent pericardial delayed hyperenhancement on magnetic resonance imaging suggests ongoing inflammation whereas calcium on computed tomography suggests a completed inflammatory cascade. In patients with ongoing pericarditis, treatments that converge on the inflammasome, such as colchicine and anakinra, have proved effective in recurrent autoinflammatory pericarditis, though further clinical trials with anakinra are warranted. Summary: An improved understanding of the pathophysiological mechanisms of pericarditis helps unravel effective therapeutic targets for this condition.

Original languageEnglish (US)
Article number60
JournalCurrent Cardiology Reports
Volume19
Issue number7
DOIs
StatePublished - Jul 1 2017

Keywords

  • Anakinra
  • Autoimmune pericarditis
  • Autoinflammatory pericarditis
  • Pericardial inflammation
  • Pericarditis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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