1. A Role for Toll-like Receptor 3 Variants in Host Susceptibility to Enteroviral Myocarditis and Dilated Cardiomyopathy
- Author
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Ryan M. David, Hua Li, Jesus G. Vallejo, Neil E. Bowles, Lori Banks, Jacquelin Varela, Chien-Hua Huang, Kimberly A Makar, Gregory Pratt, Heinz-Peter Schultheiss, Matthias Pauschinger, Jeathrina Bersola, Jeffrey A. Towbin, and Carlos Gorbea
- Subjects
Adult ,Cardiomyopathy, Dilated ,Male ,Myocarditis ,viruses ,DNA Mutational Analysis ,Molecular Sequence Data ,Cardiomyopathy ,Coxsackievirus Infections ,Endosomes ,Biology ,Virus Replication ,Biochemistry ,Cell Line ,RNA interference ,Interferon ,Autophagy ,medicine ,Animals ,Humans ,Amino Acid Sequence ,Molecular Biology ,Aged ,Enterovirus ,Toll-like receptor ,Innate immune system ,Base Sequence ,virus diseases ,Molecular Bases of Disease ,Chloroquine ,Cell Biology ,Middle Aged ,medicine.disease ,Virology ,Toll-Like Receptor 3 ,Protein Transport ,Phenotype ,Viral replication ,Mutation ,Immunology ,TLR3 ,Female ,Interferons ,medicine.drug - Abstract
The innate antiviral response is mediated, at least in part, by Toll-like receptors (TLRs). TLR3 signaling is activated in response to viral infection, and the absence of TLR3 in mice significantly increases mortality after infection with enteroviruses that cause myocarditis and/or dilated cardiomyopathy. We screened TLR3 in patients diagnosed with enteroviral myocarditis/cardiomyopathy and identified a rare variant in one patient as well as a significantly increased occurrence of a common polymorphism compared with controls. Expression of either variant resulted in significantly reduced TLR3-mediated signaling after stimulation with synthetic double-stranded RNA. Furthermore, Coxsackievirus B3 infection of cell lines expressing mutated TLR3 abrogated activation of the type I interferon pathway, leading to increased viral replication. TLR3-mediated type I interferon signaling required cellular autophagy and was suppressed by 3-methyladenine and bafilomycin A1, by inhibitors of lysosomal proteolysis, and by reduced expression of Beclin 1, Atg5, or microtubule-associated protein 1 light chain 3beta (MAP1LC3beta). However, TLR3-mediated signaling was restored upon exogenous expression of Beclin 1 or a variant MAP1LC3beta fusion protein refractory to RNA interference. These data suggest that individuals harboring these variants may have a blunted innate immune response to enteroviral infection, leading to reduced viral clearance and an increased risk of cardiac pathology.
- Published
- 2010
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