Inflammatory cytokines have an important role in the development of myocarditis, but still little is known about their prognostic importance. The aim of this study was to evaluate the prognostic value of transcriptional activity of IFN γ and two subunits of its receptor measured in the biopsy of hearts of patients with inflammatory myocariditis.

Sixty three patients with clinically confirmed myocarditis were divided into three groups according to therapy: twenty eight patients received immunosuppressive therapy (prednison and azathioprine), twenty patients were treated with atorvastatin, fifteen received only conventional therapy (without steroids and statins). Total RNA was extracted from the biopsy of specimens and the transcriptional activity of IFN γ and two subunits of its receptor (IFNRα and IFNRβ) were assessed by QRT-PCR reaction with the use of ABIPRISM 7700 and SYBRGreen chemistry. The specificity of reaction was confirmed by the melting curve profile, sequence and length of QRT-PCR products analysis.

Initial values (before therapy) of transcriptional activity of IFN γ and the ratio of two subunits of its receptors (IFNRβ/IFNRα) were statistically different between three analysed groups of patients (p = 0.0001 and p = 0.002, respectively). The prognostic value of these parameters was assessed by the logistic regression analysis. We studied the relationship between the transcriptional activity of IFN γ or the ratio IFNRβ/IFNRα in the heart (independent variable) and the probability of progresion myocarditis which require steroids (value 1) or statin (value 0) therapy. The odds ratios for IFN γ and IFNRβ/IFNRα were 57 and 3.8 respectively.

The results of the present study suggest a positive association between the elevated value of transcriptional activity of IFN  γ and the ratio IFNRβ/IFNRα in the  heart biopsy and the progression and severity of myocarditis. These parameters are useful in the choice of the appropriate pharmacological therapy for given patients based on its inflammatory status.

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