PerspectiveImmunology

Microbes and genes in heart failure

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Science  15 Nov 2019:
Vol. 366, Issue 6467, pp. 806-807
DOI: 10.1126/science.aaz4400

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Summary

Inflammation of the heart (myocarditis) is a life-threating condition that remains a poorly understood clinical entity. A variety of etiologies have been proposed; however, defining how risk factors and environmental exposures intersect has remained elusive. The multifactorial nature of host vulnerability highlights the need for a personalized medicine approach to make progress. On page 881 of this issue, Gil-Cruz et al. (1) demonstrate how a confluence of factors—including genetic predisposition, production of a commensal gut microbial autoantigen, and systemic inflammation—together trigger the generation of autoreactive CD4+ T cells that cause autoimmune myocarditis and cardiac dysfunction in animals and patients. This study highlights the parallel investigative streams required to make progress in complex diseases.

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