Comparative Proteomic Analysis of Myocarditis: COVID-19 mRNA Vaccination vs. Pre-Pandemic Viral Etiologies AHA Conference Repository

American Heart Association

Final ID: MDP204

Comparative Proteomic Analysis of Myocarditis: COVID-19 mRNA Vaccination vs. Pre-Pandemic Viral Etiologies

Abstract Body (Do not enter title and authors here): Introduction: Myocarditis has been reported after mRNA-based COVID-19 vaccination, but the immune mechanisms remain unclear. This study aimed to identify the proteome-based immunopathogenesis of post-vaccination myocarditis compared to viral myocarditis in the pre-COVID-19 era.

Methods: Proteomic analysis of right ventricle (RV) biopsy specimens was performed in myocarditis patients (pre-pandemic viral myocarditis: n=3, post-vaccination myocarditis: n=3) and controls (normal endomyocardial biopsy specimens of heart transplant recipients, n=4) using mass spectrometry. Differentially expressed proteins were analyzed with CIBERSORTx, Gene Ontology (GO) analysis, and Ingenuity Pathway Analysis (IPA). To examine the relationship between the SARS-CoV-2 spike protein and post-vaccination myocarditis, immunohistochemistry (IHC), mass spectrometry analysis of spike protein, and activation-induced marker (AIM) assay in T cells from RV samples were conducted.

Results: In the proteomic analysis, 6,861 proteins were identified. Post-vaccination myocarditis showed increased extracellular matrix formation and cardiac fibrosis. Both pre-pandemic and post-vaccination myocarditis had elevated pro-inflammatory cytokine activities. However, post-vaccination myocarditis exhibited higher expression of interferon-alpha (IFNα) and pattern recognition receptor activation, including TLR3 and TLR7. Pre-pandemic myocarditis showed higher activation of the complement system, neutrophils, and NK cells, whereas post-vaccination myocarditis showed increased Th2 cell activation and classical macrophage activation. Spike protein and related T-cell activation were not detected.

Conclusion: The immune activation in myocarditis after COVID-19 mRNA vaccination may be triggered by the mRNA in the vaccine via an IFNα-driven immune response, leading to autoimmune-like features. Further studies are necessary to validate whether these proteins correlate with clinical characteristics.

Jang, Eunsom ( St. Vincent’s Hospital, CMC , Suwon , Korea (the Republic of) )
Kim, Euisoon ( Seoul St. Mary's Hospital, CMC , Seoul , Korea (the Republic of) )
Jung, Mi-hyang ( Seoul St. Mary's Hospital, CMC , Seoul , Korea (the Republic of) )
Kim, In-cheol ( Keimyung University , Daegu , Korea (the Republic of) )
Kim, Jong-seo ( Seoul National University , Seoul , Korea (the Republic of) )
Youn, Jong-chan ( Seoul St. Mary's Hospital, CMC , Seoul , Korea (the Republic of) )

Author Disclosures:

Eunsom Jang:

DO NOT have relevant financial relationships

Euisoon Kim:

No Answer

Mi-Hyang Jung:

DO NOT have relevant financial relationships

In-Cheol Kim:

No Answer

Jong-Seo Kim:

No Answer

Jong-Chan Youn:

DO NOT have relevant financial relationships

Meeting Info:

Scientific Sessions 2024

2024

Chicago, Illinois

Session Info:

COVID-19 and Heart Failure

Saturday, 11/16/2024 , 11:10AM - 12:35PM

Moderated Digital Poster Session

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Comparative Proteomic Analysis of Myocarditis: COVID-19 mRNA Vaccination vs. Pre-Pandemic Viral Etiologies

Meeting Info:

Session Info:

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