The Role of Sex Differences in Autophagy in the Heart During Coxsackievirus B3-Induced Myocarditis

Under normal conditions, autophagy maintains cardiomyocyte health and integrity through turnover of organelles. During stress, oxygen and nutrient deprivation, or microbial infection, autophagy prolongs cardiomyocyte survival. Sex differences in induction of cell death may to some extent explain the disparity between the sexes in many human diseases. However, sex differences in gene expression, which regulate cell death and autophagy, were so far not taken in consideration to explain the sex bias of viral myocarditis. Coxsackievirus B3 (CVB3)-induced myocarditis is a sex-biased disease, with females being substantially less susceptible than males and sex hormones largely determine this bias. CVB3 was shown to induce and subvert the autophagosome for its optimal viral RNA replication. Gene expression analysis on mouse and human, healthy and CVB3-infected, cardiac samples of both sexes, suggests sex differences in autophagy-related gene expression. This review discusses the aspects of sex bias in autophagy induction in cardiomyocytes.     

When should FDG‐PET be used in the modern management of lymphoma?

Positron Emission Tomography (PET) is a functional imaging technique that, combined with computerized tomography (PET‐CT), is increasingly used in lymphoma. Most subtypes accumulate fluorodeoxyglucose (FDG) and the increased sensitivity of PET‐CT, especially for extranodal disease, compared to CT, makes PET‐CT an attractive staging tool. The availability of a staging PET‐CT scan also improves the accuracy of subsequent response assessment. ‘Interim’ PET‐CT can be used to assess early response and end‐of‐treatment PET‐CT assesses remission. Clinical trials are currently seeking to establish whether the predictive value of PET‐CT can be successfully used to guide individual treatment to reduce toxicity and/or to improve outcomes. Standardized methods for performing and reporting PET have been developed in the context of trials. The role of PET in transplantation selection is currently evolving, as it appears to be more accurate and prognostic than CT. The role of FDG PET‐CT throughout the management course in patients with lymphoma is explored in this review, with areas discussed that may limit the use of PET‐CT imaging which clinicians should be familiar with to inform practice.