The clinical phenotype of human dilated cardiomyopathy (DCM) encompasses a broad spectrum of etiologically distinct disorders.
As targeting of etiology-related pathogenic pathways may be more efficient than current standard heart failure treatment,
we obtained the genomic expression profile of a DCM subtype characterized by cardiac inflammation to identify possible new
therapeutic targets in humans. In this inflammatory cardiomyopathy (DCMi), a distinctive cardiac expression pattern not described
in any previous study of cardiac disorders was observed. Two significantly altered gene networks of particular interest and
possible interdependence centered around the cysteine-rich angiogenic inducer 61 (CYR61) and adiponectin (APN) gene. CYR61
overexpression, as in human DCMi hearts in situ, was similarly induced by inflammatory cytokines in vascular endothelial cells
in vitro. APN was strongly downregulated in DCMi hearts and completely abolished cytokine-dependent CYR61 induction in vitro.
Dysbalance between the CYR61 and APN networks may play a pathogenic role in DCMi and contain novel therapeutic targets. Multiple
immune cell-associated genes were also deregulated (e.g., chemokine ligand 14, interleukin-17D, nuclear factors of activated
T cells). In contrast to previous investigations in patients with advanced or end-stage DCM where etiology-related pathomechanisms
are overwhelmed by unspecific processes, the deregulations detected in this study occurred at a far less severe and most probably
fully reversible disease stage.
Keywords Human inflammatory cardiomyopathy - Genomic expression profiling - Molecular therapeutic targets - Molecular pathomechanisms - Dilated cardiomyopathy - Heart failure
The mesenchymal stem cells protein DSC96 was 4.8-fold (q<0.371) downregulated in the DCMi group.
F. Wittchen and L. Suckau contributed equally to this paper.