Enteroviral cardiomyopathy: Bad news for the dystrophin-glycoprotein complex

Genetic deficiency of the dystrophin-glycoprotein complex causes hereditary dilated cardiomyopathy. Enteroviruses can also cause cardiomyopathy and we have recently described a potential molecular mechanism for enterovirus-in duced dilated cardiomyopathy. The coxsackieviral protease 2A proteolyticall y cleaves and functionally impairs dystrophin. Additionally, during infecti on with coxsackievirus B3, the dystrophin-glycoprotein complex becomes disr upted and the sarcolemmal integrity is lost. This review article discusses the importance of the dystrophin cleavage for the development of increased sarcolemmal permeability and potential pathwa ys for mechanisms by which the dystrophin cleavage during coxsackieviral in fection may contribute to dilated cardiomyopathy.