Background: Myocarditis can develop into dilated cardiomyopathy (DCM), which may require heart transplantation (HTx). The immunological network of myocarditis phases remains unknown. This study aimed to investigate the immunological network during the transition from myocarditis to cardiomyopathy and to identify the genes contributing to the inflammatory response to myocarditis. Methods: Mice were treated with myosin heavy-chain-α peptides to generate an experimental autoimmune myocarditis (EAM) model. We performed single-cell RNA sequencing (scRNA-seq) analysis of Cd45+ cells extracted from mouse hearts during different EAM phases, including normal control, acute inflammatory, subacute inflammatory and myopathy phases. Human heart tissues were collected from the surgically removed hearts of patients who had undergone HTx. Results: We identified 26 cell subtypes among 34,665 cells. Macrophages constituted the main immune cell population at all disease phases (greater than 60%), and an inflammation-associated macrophage cluster was identified in which the expression of Hif1a-regulated genes was upregulated. The neutrophil population was increased after the induction of EAM, and neutrophils then released Il-1 to participate in the EAM process. T cells were observed at the highest percentage at the subacute inflammatory phase. Th17 cells, in which the expression of Hif1a-regulated genes was upregulated, constituted the main T cell population detected at the acute inflammatory phase, while Treg cells were the main T cell population detected at the subacute inflammatory phase, and γδ T cells releasing Il-17 were the main T cell population observed at the myopathy phase. Moreover, the Hif1a expression level correlated with the extent of inflammation. Additionally, PX-478 could alleviate the inflammatory responses of the different EAM phases. Finally, HIF1A was expressed at higher levels in acute autoimmune myocarditis patients than in DCM patients and healthy controls. Conclusions: We herein present a comprehensive single-cell landscape of the cardiac immune cells in different EAM phases. In addition, we elucidated the contribution of Hif1a to the inflammatory response through the regulation of immune cell activity, particularly of macrophage cluster 2 and Th17 cells. Moreover, a Hif1a inhibitor alleviated inflammatory cell infiltration of the EAM model and may serve as a potential therapeutic target in the clinic.
Keywords: Hif1a; dynamic changes; experimental autoimmune myocarditis; immunological network; single-cell sequencing.
Inhibition of microRNA-155 ameliorates experimental autoimmune myocarditis by modulating Th17/Treg immune response.J Mol Med (Berl). 2016 Sep;94(9):1063-79. doi: 10.1007/s00109-016-1414-3. Epub 2016 Apr 6. J Mol Med (Berl). 2016. PMID: 27052830
STAT4 silencing underlies a novel inhibitory role of microRNA-141-3p in inflammation response of mice with experimental autoimmune myocarditis.Am J Physiol Heart Circ Physiol. 2019 Sep 1;317(3):H531-H540. doi: 10.1152/ajpheart.00048.2019. Epub 2019 Jun 21. Am J Physiol Heart Circ Physiol. 2019. PMID: 31225989
T cells with similar T-cell receptor beta-chain complementarity-determining region 3 motifs infiltrate inflammatory lesions of synthetic peptides inducing rat autoimmune myocarditis.Circ Res. 1998 Jul 27;83(2):133-40. doi: 10.1161/01.res.83.2.133. Circ Res. 1998. PMID: 9686752
Regulation of inflammation and myocardial fibrosis in experimental autoimmune myocarditis.Inflamm Allergy Drug Targets. 2011 Jun;10(3):218-25. doi: 10.2174/187152811795564091. Inflamm Allergy Drug Targets. 2011. PMID: 21495969 Review.
Pathogenesis of myocarditis and dilated cardiomyopathy.Adv Immunol. 2008;99:95-114. doi: 10.1016/S0065-2776(08)00604-4. Adv Immunol. 2008. PMID: 19117533 Review.