The Myocarditis Foundation is Pleased to Announce the 2017 Sarah Knight Fellowship Grant Recipient

Awarded grant in 2017

The Myocarditis Foundation is pleased to announce our 2017 Fellowship Grant Recipient, Dr. Paul Hanson, PhD, of the University of British Columbia/St. Paul’s Hospital, for the 2018-2019 Academic Year. Dr. Hanson’s research rose to the top of the research applications this year, with his research submission titled: “Personalizing Myocarditis Diagnostics through Novel Biomarkers.” To achieve a more accurate and personalized diagnosis for myocarditis, this lab has learned from valuable mouse models of viral myocarditis, and will be applying that knowledge to human myocarditis diagnostic development.

Dr. Hanson’s Fellowship Grant is named after a Viral Myocarditis victim, Sarah Knight, whose family has been raising funds to support research into myocarditis since she passed away from it in 2011. Read Sarah’s Real Life Story Here.

Please read more about Dr. Hanson’s work in the Layman’s Summary of his work below:

The Problem of Myocarditis: Myocarditis is a term to denote inflammation and injury of the heart muscle or myocardium. Myocarditis is a major cause of sudden and unexpected death in young people including children. Viruses that infect the heart muscle are a common cause of myocarditis, resulting in inflammation and tissue damage. This damage is significant because injured heart muscle cells cannot contract effectively, and individuals afflicted with myocarditis will develop failure of the heart pump that requires medical or surgical intervention, including heart transplantation or artificial heart pumps, for survival. Young people affected by viral myocarditis are at even greater peril as they may develop heart failure right away or decades later.

How the Diagnosis of Myocarditis Is Usually Made: To help minimize the damage and devastating outcomes, an early proper diagnosis is required. The gold standard (most certain method) for diagnosing myocarditis is via a biopsy of the heart. Tissue is snipped from the pumping chamber muscle and is examined for evidence of inflammation and tissue damage. Yet, under the current established procedures, a correct diagnosis can only be made in 30% or fewer of patients that actually have myocarditis. Not all parts of the heart muscle will be equally involved by the disease, so the biopsy may miss the inflammation and damage. Thus, the current diagnostic approach is not sufficiently sensitive. Significant advances have occurred in our understanding of the biology underlying such conditions as myocarditis since the time that the initial biopsy guidelines were developed in the 1980’s. We believe these modern diagnostic tools will dramatically improve on our ability to make the diagnosis of myocarditis, resulting in better management and outcomes for patients.

A New Approach to Diagnosis of Myocarditis: To achieve a more accurate and personalized diagnosis for myocarditis, our laboratory is learning from valuable mouse models of viral myocarditis, and applying that knowledge to human myocarditis diagnostic development. We have discovered increased amounts of certain proteins are associated with heart muscle failure -in the setting of viral infection (myocarditis) in mice when compared to the hearts of healthy uninfected mice. Importantly, these particular proteins could be detected even in sections of the heart without the characteristic inflammation and tissue damage usually considered necessary for diagnosis. Further, this pattern of increased protein expression appears to be specific to viral myocarditis as compared to other causes of heart failure. Our preliminary work in human heart muscle has revealed increased amounts of these same proteins in human myocarditis, suggesting that they are biomarkers of viral myocarditis, or in other words, biological hallmarks of this particular disease state. We are now examining whether detection of these proteins provides for improved diagnosis in myocarditis. Ultimately, if these increased proteins are part of the disease process stimulated by the virus, they could become targets for new therapies.

Important Next Steps Made Possible by the Myocarditis Foundation: Our work will start with an examination of whether staining for these biomarkers on heart biopsy tissue will consistently improve the ability of pathologists (laboratory physicians) to diagnose myocarditis after biopsy is performed. The experiments we have performed thus far suggest that this approach will be successful, possibly achieving accurate diagnosis about 80% of the time. But this needs to be rigorously demonstrated. Following on this work, we anticipate being able to
detect fragments of these proteins generated during the disease process in the blood of patients
with myocarditis. If this latter approach is successful, we may be able to develop blood tests that
will improve our ability to diagnose myocarditis, perhaps reducing the need for an invasive heart
biopsy.

Potential Impact and Significance: Perhaps the most exciting and challenging aspect of this
scientific work is the potential to provide new knowledge about how the proteins function and
contribute to the disease process during human myocarditis. New treatments may arise.
Currently, most treatment for myocarditis is supportive, aimed at only treating symptoms and
supporting the weakened heart muscle. By better understanding the disease, we can develop
more specific therapies, aimed at actually eliminating the disease before it causes severe heart
damage and heart failure. Similar work in future studies will allow for each of the different
causes of myocarditis to be better identified and managed, with each patient receiving the right
treatment at the right time in a personalized fashion.