TITLE:
Myocarditis—Personalized Medicine by Expanded Endomyocardial Biopsy Diagnostics
AUTHORS:
Dirk Lassner, Maria Rohde, Christine Sabine Siegismund, Uwe Kühl, Ulrich Michael Gross, Felicitas Escher, Carsten Tschöpe, Heinz-Peter Schultheiss
KEYWORDS:
Cardiomyopathy, Endomyocardial Biopsy, Personalized Medicine, Biomarker, MicroRNAs
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.4 No.6,
May
30,
2014
ABSTRACT: Myocarditis and dilated cardiomyopathy (DCM) are acute or chronic disorders of myocardium. The gold standard for final confirmation of causative reasons of these heart muscle diseases is the endomyocardial biopsy (EMB) analysis. Due to focal pathology, diagnostics are failing if the EMB does not contain the area of interest. Personalized medicine comprises the genetic information together with the phenotypic and environmental factors to yield a tailored healthcare for each individual and removes the limitations of the “one-size-fits-all” therapy approach. This provides the opportunity to translate therapies from bench to bedside, to diagnose and predict disease, and to improve patient-tailored treatments based on the unique signatures of a patient’s disease. Furthermore, novel treatment schedules can be identified which have eventually the chance to enhance long-term survivals. Global biomarkers such as specific gene expression signatures or miRNA profiles not only have the potential to reduce this problem but also add valuable information for individualized therapy decisions. In future, multiplex approaches allowing rapid and absolutely reliable identification of inflammatory or virally-induced myocardial diseases will replace singleplex methods such as direct detection of viral genomes in one single biopsy. Gene or miRNA profiles are upcoming diagnostic biomarkers for cardiomyopathies which are not only detectable in tissue samples but in body fluids as well. Consequently, a systemic diagnostic approach by determination of distinct expression pattern in e.g., peripheral blood samples will support the characterization of distinct cardiomyopathies by means of non-invasive methods.