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Cited by 47Viral Infections and Immunology ResearchCardiac Fibrosis and RemodelingOcular Diseases and Behçet’s Syndrome

Sex-Specific Differences of the Inflammatory State in Experimental Autoimmune Myocarditis

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Barcena, Maria Luisa, Jeuthe, Sarah, Niehues, Maximilian H., Pozdniakova, Sofya, Haritonow, Natalie, Kühl, Anja A., Messroghli, Daniel R., Regitz-Zagrosek, Vera·2021·Frontiers in Immunology
DOI 10.3389/fimmu.2021.686384PMC PMC8195335
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Abstract

Increasing evidence suggests male sex as a potential risk factor for a higher incidence of cardiac fibrosis, stronger cardiac inflammation, and dilated cardiomyopathy (DCM) in human myocarditis. Chronic activation of the immune response in myocarditis may trigger autoimmunity. The experimental autoimmune myocarditis (EAM) model has been well established for the study of autoimmune myocarditis, however the role of sex in this pathology has not been fully explored. In this study, we investigated sex differences in the inflammatory response in the EAM model. We analyzed the cardiac function, as well as the inflammatory stage and fibrosis formation in the heart of EAM male and female rats. 21 days after induction of EAM, male EAM rats showed a decreased ejection fraction, stroke volume and cardiac output, while females did not. A significantly elevated number of infiltrates was detected in myocardium in both sexes, indicating the activation of macrophages following EAM induction. The level of anti-inflammatory macrophages (CD68+ ArgI+) was only significantly increased in female hearts. The expression of Col3A1 and fibrosis formation were more prominent in males. Furthermore, prominent pro-inflammatory factors were increased only in male rats. These findings indicate sex-specific alterations in the inflammatory stage of EAM, with a pro-inflammatory phenotype appearing in males and an anti-inflammatory phenotype in females, which both significantly affect cardiac function in autoimmune myocarditis.

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  • Male mice develop more consistent and severe EAM than females, exhibiting stronger pro-inflammatory macrophage responses, greater cardiac infiltration, and more pronounced fibrotic remodelling.

    “This was a deliberate experimental decision, as male mice develop more consistent and severe EAM than females, exhibiting stronger pro-inflammatory macrophage responses, greater cardiac infiltration, and more pronounced fibrotic remodelling, which are features that are well-documented in both autoimmune and viral myocarditis models and align with the higher incidence and severity of myocarditis”

    From Cardiac Macrophages Exhibit Dynamic Heterogeneity and Functional Specialization During Experimental Autoimmune Myocarditis. (2026) · cites this paper as [32]

    The Discussion and Results report stronger pro-inflammatory macrophage responses, more cardiac infiltrates, and greater fibrosis in male EAM rats than in females. The cited study used rats, not mice, and the passages do not establish that males develop EAM more consistently. (LLM, conf=0.90)

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Authors
Barcena, M. L., Jeuthe, S., Niehues, M. H., Pozdniakova, S., Haritonow, N., Kühl, A. A., Messroghli, D. R., & Regitz-Zagrosek, V.
Affiliations
  • Humboldt-Universität zu Berlin (DE)
  • Deutsches Herzzentrum der Charité (DE)
Corresponding author
Barcena, Maria Luisa
ORCID
Venue
Frontiers in Immunology
Publisher
Frontiers Media SA
Published
2021-05-28
Volume
12
Pages
686384-686384
ISSN
1664-3224 (ISSN-L)
DOI
10.3389/fimmu.2021.686384
PMC
PMC8195335
OpenAlex
W3171790011
Cited by
47
References
10
Citations by year
2026: 12 · 2025: 8 · 2024: 7 · 2023: 11 · 2022: 7 · 2021: 2
FWCI
4.69
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Immunology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Refubium (Universitätsbibliothek der Freien Universität Berlin) (submittedVersion, cc-by)
  • Universitätsbibliothek der FU Berlin Hochschulschriftenstelle u. Dokumentenserver (cc-by)
Funders
Deutsches Zentrum für Herz-Kreislaufforschung
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Viral Infections and Immunology Research
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Fibrosis and Remodeling
  • Health Sciences › Medicine › Ophthalmology › Ocular Diseases and Behçet’s Syndrome
Keywords
experimental autoimmune myocarditis, sex differences, cardiac inflammation, myocardial fibrosis, macrophage polarization, anti-inflammatory macrophages, inflammatory cytokines, cardiac function, dilated cardiomyopathy, type III collagen, Arg1, CD68
MeSH terms
Animals, Autoimmune Diseases, Female, Fibrosis, Macrophages, Male, Myocarditis, Myocardium, Rats, Inbred Lew, Sex Characteristics, Cytokines, Collagen Type III, Rats

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