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Cardioimmunology of arrhythmias: the role of autoimmune and inflammatory cardiac channelopathies

Nature Reviews Immunology volume 19, pages 63–64 (2019)Cite this article

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We have read with great interest the excellent review on cardioimmunology by Filip K. Swirski & Matthias Nahrendorf (Cardioimmunology: the immune system in cardiac homeostasis and disease. Nat. Rev. Immunol. 18, 733–744 (2018))1. The authors extensively discussed the role of immune cells in normal and diseased heart, specifically in myocardial infarction, myocarditis and endocarditis, heart failure and rhythm disorders1. Regarding rhythm disorders, they speculated that the immune system could contribute to arrhythmias through two mechanisms — a crosstalk between immune cells and fibroblasts and/or myocytes, leading to insulating fibrosis, or a direct participation of leukocytes (macrophages) in the electrical regulation of conducting cells, by interacting through connexin 43 (CX43)-containing gap junctions1.

However, the authors substantially disregarded a third important mechanism of arrhythmias in this new field of immuno-cardiac electrophysiology. In fact, accumulating data indicate that the immune system can promote cardiac arrhythmias by means of autoantibodies and/or inflammatory cytokines that directly affect the function of specific ion channels on the surface of cardiomyocytes2,3,4.

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Fig. 1: Autoimmune and inflammatory cardiac channelopathies and arrhythmias: molecular basis.

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Author notes

  1. These authors contributed equally: Franco Laghi-Pasini, Mohamed Boutjdir, Pier Leopoldo Capecchi.

Authors and Affiliations

  1. Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy

    Pietro Enea Lazzerini, Franco Laghi-Pasini & Pier Leopoldo Capecchi

  2. VA New York Harbor Healthcare System, SUNY Downstate Medical Center, New York, NY, USA

    Mohamed Boutjdir

  3. NYU School of Medicine, New York, NY, USA

    Mohamed Boutjdir

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  1. Pietro Enea Lazzerini
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  2. Franco Laghi-Pasini
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Correspondence to Pietro Enea Lazzerini.

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Lazzerini, P.E., Laghi-Pasini, F., Boutjdir, M. et al. Cardioimmunology of arrhythmias: the role of autoimmune and inflammatory cardiac channelopathies. Nat Rev Immunol 19, 63–64 (2019). https://doi.org/10.1038/s41577-018-0098-z

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