The risk of heart disease is greatly increased by high cholesterol and blood pressure, smoking, and diabetes, but fortunately the health of their heart can be protected by making healthy lifestyle choices. Nevertheless, according to the World Health Organization (WHO), heart disease is today the most common cause of mortality, including in Estonia. It is estimated that a couple of thousand people die of heart failure in Estonia every year. 

Heart failure can be caused by viruses

While various scientific studies have shown that cardiovascular diseases can also be caused by bacteria and viruses, the causes and mechanisms of such pathogen-related heart damage have remained unclear.

To shed light on the matter, a group of researchers led by Dr. Kaia Palm, CEO of the Estonian biotechnology company Protobios OÜ, in collaboration with researchers from the Tallinn University of Technology, the North Estonia Medical Centre, the University of Helsinki, and Helsinki University Hospital, undertook a study on immune response analysis in heart health.

Excellent use of phage display technology

For immune response analysis, the researchers used mimotope variation analysis, or MVA – a next-generation technology that is patented by Protobios and enables to investigate changes in antibody immune response. The method allows researchers to generate personal immune response profiles, which in turn make it possible to determine the individual’s immunological health and predict the risk of chronic diseases on the basis of these indicators. About 800 individual immune response profiles were analysed for the study.

A strong  anti-viral immune response and a well-known vaccine might be the solution!

The study found that, unlike cardiac patients, healthy individuals exhibit a strong immune response to a particular epitope of the VP1 capsid protein that is highly conserved across the enteroviral species. This widespread virus group includes, notably, the poliovirus – the causative agent of polio, also known as poliomyelitis –, epidemics of which have been effectively kept under control by an oral vaccine developed in the 1960s, which has also been administered in Estonia throughout several decades.

The results of the study indicate that a strong specific immune response to the particular epitope, whether induced by a polio vaccine or enterovirus infection, protects against the development of severe heart conditions. Thus, a strong immune response against the highly conserved enteroviral epitope of the capsid protein antigen is directly related to the risk of cardiac diseases.

Juha Sinisalo, a professor of cardiology at Helsinki University Hospital, considers the discovery of a strong antibody response induced by vaccination against the poliovirus to be significant, as such a response can protect against acute heart events, including myocardial infarction.

Who participated in the research?

The results of the research were recently published in the Lancet’s prestigious journal EBioMedicine, in an article titled Immune response to a conserved enteroviral epitope of the major capsid VP1 protein is associated with lower risk of cardiovascular disease. The authors of the research and the article are Nadežda Pupina, Annela Avarlaid, Helle Sadam, Arno Pihlak, Mariliis Jaago, Jürgen Tuvikene, Annika Rähni, Anu Planken, Margus Planken, Eija Kalso, Pentti J. Tienari, Janne K. Nieminen, Mikko Seppänen, Antti Vaheri, Dan Lindholm, Juha Sinisalo, Pirkko Pussinen, Tõnis Timmusk, and Kaia Palm. Nadežda Pupina, the lead author of the article, holds a master’s degree in gene technology from the Tallinn University of Technology. Annela Avarlaid, Helle Sadam, Mariliis Jaago, and Annika Rähni are doctoral students at the Department of Chemistry and Biotechnology of the Tallinn University of Technology.

The research article can be read in the journal eBioMedicine: “Immune response to a conserved enteroviral epitope of the major capsid VP1 protein is associated with lower risk of cardiovascular disease”