1. Academic Validation
  2. Plasma proteomics identifies S100A8/A9 as a novel biomarker and therapeutic target for fulminant myocarditis

Plasma proteomics identifies S100A8/A9 as a novel biomarker and therapeutic target for fulminant myocarditis

  • J Adv Res. 2025 Jun 4:S2090-1232(25)00391-1. doi: 10.1016/j.jare.2025.06.005.
Wu He 1 Junfang Wu 1 Dongxue Wang 2 Wendong Chen 3 Yongcui Yan 1 Qiongyao He 4 Chenze Li 5 Qianying Yang 3 Chuanxi Huang 3 Zheng Wen 1 Chen Chen 1 Fuchu He 2 Liujun Tang 6 Dao Wen Wang 7
Affiliations

Affiliations

  • 1 Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan 430000, China.
  • 2 State Key Laboratory of Medical Proteomics, Beijing Proteome Research Center, National Center for Protein Science (Beijing), Beijing Institute of Lifeomics, Beijing 102206, China; International Academy of Phronesis Medicine (Guang Dong), Guangzhou 510000, China.
  • 3 International Academy of Phronesis Medicine (Guang Dong), Guangzhou 510000, China.
  • 4 Department of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
  • 5 Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China; Hubei Provincial Clinical Research Center for Cardiovascular Intervention, Wuhan, China; Institute of Myocardial Injury and Repair, Wuhan University, Wuhan 430071, China.
  • 6 State Key Laboratory of Medical Proteomics, Beijing Proteome Research Center, National Center for Protein Science (Beijing), Beijing Institute of Lifeomics, Beijing 102206, China. Electronic address: tangliujun111@163.com.
  • 7 Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan 430000, China. Electronic address: dwwang@tjh.tjmu.edu.cn.
Abstract

Introduction: Fulminant myocarditis (FM) is a lethal inflammatory myocardial disease characterized by rapid progression and poor prognosis. Investigating plasma proteins linked to FM may elucidate underlying pathological mechanisms, identify novel biomarkers for early detection in high-risk populations, and advance the development of targeted therapeutic strategies.

Objectives: This study aimed to investigate the proteomic profiles of FM patients and identify potential biomarkers and therapeutic targets, focusing on S100A8/S100A9.

Methods: We conducted a comprehensive proteomic analysis of an extensive plasma sample collection derived from FM patients across three clinical cohorts. Our approach included screening for proteins correlated with cardiac dysfunction and disease severity. Key findings were validated in an independent cohort. In parallel, we employed a CVB3-induced FM mouse model to evaluate the expression of these biomarkers in myocardial tissue and assessed the effects of targeted interventions. Specifically, we investigated the therapeutic impacts of blocking the S100A8/A9 heterodimer using the inhibitor ABR-238901.

Results: The analysis revealed significant innate immune activation and severe metabolic disturbances in FM patients. Through proteomic profiling and correlation analysis, proteins S100A8 and S100A9 emerged as significant biomarkers linked to cardiac dysfunction and FM severity. S100A8/A9 heterodimer was validated as a crucial diagnostic marker for FM, with elevated plasma levels correlating with increased rates of cardiac death, heart transplantation, and hospitalizations due to heart failure or myocarditis. In CVB3-induced FM mouse models, myocardial tissues showed increased levels of S100A8 and S100A9. Treatment with ABR-238901 significantly reduced mortality by alleviating acute inflammation and improving cardiac function.

Conclusion: S100A8/A9 emerged as an essential biomarker and a promising therapeutic target for FM. These findings offer new insights into FM diagnosis and suggest potential intervention strategies. These results pave the way for further research to validate the clinical application of S100A8/A9-targeted therapies, potentially improving outcomes for patients suffering from this severe cardiac condition.

Trial registration: ClinicalTrials.gov NCT03268642.

Keywords

Biomarker; Fulminant myocarditis; Plasma proteomic; S100A8/A9; Therapeutic target.

Figures
Products