Myocarditis, is an inflammatory disease of the myocardium, is categorized into three main groups including post-viral autoimmune-related, autoimmune-mediated (lupus myocarditis, giant-cell myocarditis) and drug-associated (hypersensitivity myocarditis, toxic myocarditis).
However, more than 50% of the cases of myocarditis are post-viral immune-related in the setting of an identifiable or nonidentifiable infection. Patients are commonly asymptomatic or present with nonspecific symptoms including fever, fatigue and arthralgia. Some also experience dyspnoea or cardiac signs from angina and arrhythmia to heart failure, dilated cardiomyopathy or sudden death.
The annual prevalence is estimated to be nearly 17 per 100,000 population worldwide. The diagnosis of myocarditis cannot be made by myocardium inflammation alone since many diseases such as myocardial infarction can also cause secondary inflammation.
The main inflammatory cells that infiltrate the heart during myocarditis are T-lymphocytes, macrophages and NK cells. The initial management of myocarditis is treatment of the underlying diseases, but cardiac symptoms require additional medications such as digoxin, diuretics, ACE inhibitors, ARBs, beta blockers and corticosteroids.
Nevertheless, effective treatment strategies for myocarditis are still limited. Recently, natural compounds and herbal medicines are found to exert protective effects against mortality in viral myocarditis. Phytochemical have been traditionally used in the treatment of various diseases including cardiovascular disorders
As myocarditis is inflammation of the heart muscle. Turmeric’s anti-inflammatory properties can help. A study published in the Journal of Cardiovascular Pharmacology and Therapeutics, 2013 demonstrated curcumin’s therapeutic efficacy in viral myocarditis. It was found that curcumin brought down levels of inflammatory enzymes by acting on key proteins involved in inflammation. Mito et.al have proven via an animal study that curcumin counteracts inflammation in autoimmune myocarditis. Other studies point that curcumin’s immunomodulatory (ability to regulate immune function) and antioxidant action protect heart function in autoimmune myocarditis. These properties can help in protecting heart function and preventing the progress of myocarditis, thus making curcumin a novel therapy in myocarditis.
To conclude, natural phytochemicals, such as curcumin, found in turmeric, may represent favourable therapeutic agents in combination with conventional therapy in myocarditis and its associated complications, what might be especially important now in the time of pandemic and the higher risk of myocarditis both in the acute Covid-19 and during Long-Covid.
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AyeshehEnayati, MaciejBanach, TannazJamialahmadi, AmirhosseinSahebkar, endorsed by the International Lipid Expert Panel (ILEP)https://doi.org/10.1016/j.biopha.2021.112242
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