Original Article
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World J Cardiol. Apr 26, 2014; 6(4): 183-195
Published online Apr 26, 2014. doi: 10.4330/wjc.v6.i4.183
Molecular phenotypes of human parvovirus B19 in patients with myocarditis
C-Thomas Bock, Anja Düchting, Friederike Utta, Eva Brunner, Bui Tien Sy, Karin Klingel, Florian Lang, Meinrad Gawaz, Stephan B Felix, Reinhard Kandolf
C-Thomas Bock, Anja Düchting, Friederike Utta, Eva Brunner, Karin Klingel, Reinhard Kandolf, Department of Molecular Pathology, University Hospital of Tuebingen, 72076 Tuebingen, Germany
C-Thomas Bock, Bui Tien Sy, Robert Koch Institute, 13353 Berlin, Germany
Florian Lang, Department of Physiology, University of Tuebingen, 72070 Tuebingen, Germany
Meinrad Gawaz, Department of Cardiology and Cardiovascular Medicine, University Hospital of Tuebingen, 72076 Tuebingen, Germany
Stephan B Felix, Clinics for Internal Medicine B, Ernst-Moritz-Arndt-University, 17475 Greifswald, Germany
Author contributions: Bock CT, Gawaz M, Felix SB and Kandolf R conceived and designed the research; Bock CT, Düchting A, Utta F, Brunner E, Sy BT, Klingel K, Lang F and Kandolf R performed the experiments; Bock CT, Klingel K, Lang F, Gawaz M, Felix SB and Kandolf R analyzed the data; Klingel K, Gawaz M, Felix SB and Kandolf R contributed to reagents/materials/analysis tools; Bock CT and Kandolf R contributed to drafting of the manuscript; all authors read and approved the final manuscript.
Supported by Grants of the Deutsche Forschungsgemeinschaft, Sonderforschungsbereich-Transregio 19 (project B5)
Correspondence to: C-Thomas Bock, PhD, Director, Professor, Department of Molecular Pathology, University Hospital of Tuebingen, Liebermeisterstr. 8, 72076 Tuebingen, Germany. bockc@rki.de
Telephone: + 49-30-187542379 Fax: + 49-30-187542617
Received: October 11, 2013
Revised: January 16, 2014
Accepted: February 18, 2014
Published online: April 26, 2014
Core Tip

Core tip: Human parvovirus B19 (B19V) has recently been shown to be an emerging pathogen for inflammatory cardiomyopathy (iCMP). We showed that B19V replication intermediates could be detected in acute and ongoing myocarditis. B19V-genotypes 1 and 2 were predominant although B19V-genotype 2 was more prevalent in iCMP. Further analyses revealed that B19V-coinfection with other cardiotropic viruses does occur, most frequently with human herpes virus 6 (HHV6). In vitro experiments showed that the HHV6 U94-transactivator element could transactivate the B19V-P6-promoter. We suggest that long-term persistence of B19V DNA in the human heart occurs and that active/reactivated B19V-replication can be associated with iCMP in a viral load and genotype-dependent manner.