Abstract Body: Background: Understanding what factors perpetuate cardiac inflammation in patients with unremitting inflammatory dilated cardiomyopathy (iDCM) is critical for developing curative therapies. We have previously demonstrated that inflammatory fibroblasts (IFs), a subset of cardiac fibroblasts (CFs) that promote inflammation, depend on IL-17A signaling to drive iDCM progression in experimental autoimmune myocarditis. Here, we demonstrate that IL-1 signaling more potently activates IFs than IL-17A. IL-1 signaling has been implicated in the pathogenesis of viral myocarditis, the most common etiology of myocarditis, though the mechanism is unclear.

Hypothesis: We hypothesize that IL-1 signaling to CFs induces their differentiation into IFs, which drive pathogenic inflammation during viral myocarditis.

Methods: Primary murine CF cultures were used to characterize IF activation by various cytokines. Next, we both performed qPCR on sorted CFs and used a CCL2-mCherry reporter mouse line to phenotype IF activation during Coxsackievirus B3 (CVB3) myocarditis. Finally, in-vivo fibroblast-specific IL-1 signaling was genetically ablated using PDGFRα^creIL1r1^fl/fl mice. We infected PDGFRα^cre and PDGFRα^creIL1r1^fl/fl mice with CVB3 and assessed myocarditis severity during the peak of inflammation using histological scoring and flow cytometry.

Results: Innate, Th1, Th2, and Th17 related cytokines such as IL-1β, IFNγ, IL-13, and IL-17A induced unique IF gene expression signatures. IL-1β most potently activated IFs with a pro-myeloid cytokine inflammatory profile. During CVB3 myocarditis, IF activation peaked on day 3 post infection and was sustained until day 10. Ablating IL-1 signaling to CFs reduced the magnitude of cardiac inflammation by 45% ± 14% (p=0.002) during the peak of CVB3 myocarditis with a reduction in monocyte, CD4+ T cells, CD8+ T cells, and NK cell recruitment. Gene expression analysis of sorted CFs from mutant and control mice revealed reduced expression of pro-myeloid chemokines such as CXCL1 and CCL2 on day 3 of CVB3 myocarditis.

Conclusions: Cardiac fibroblasts exhibit remarkable plasticity allowing them to respond to a changing micro-environment. Blocking IL-1 signaling to IFs during CVB3 myocarditis inhibited production of pro-inflammatory chemokines resulting in attenuation of myocardial inflammation. Therefore, early IF activity acts as a rheostat to modulate the magnitude of cardiac inflammation during myocarditis.