Enhanced ISGylation via USP18 Isopeptidase Inactivation Fails to Mitigate the Inflammatory or Functional Course of Coxsackievirus B3-Induced Myocarditis.

Background/aims: The ubiquitin-like protein ISG15 and its covalent conjugation to substrates (ISGylation) represent a critical interferon (IFN)-induced antiviral mechanism. USP18 is an ISG15-specific isopeptidase and a key negative regulator of type I IFN signaling. While inactivation of USP18's catalytic activity enhances ISGylation and promotes viral resistance, its role in modulating inflammation and cardiac function during CVB3-induced myocarditis remains unclear. This study aimed to determine whether selective inactivation of USP18 isopeptidase activity influences the inflammatory and functional course of viral myocarditis.

Methods: Usp18 C61A/C61A knock-in mice, which lack USP18 isopeptidase activity but retain IFN regulatory function, were used on both C57BL/6 and A/J backgrounds. Mice were infected with the cardiotropic CVB3-Nancy strain, and disease progression was assessed through virological, histological, immunological, and echocardiographic analyses. Immune cell infiltration was quantified by flow cytometry, and ISGylation was assessed by immunoblotting.

Results: Despite enhanced ISGylation, Usp18 C61A/C61A mice did not exhibit altered cardiac viral titers or inflammation compared to wild-type controls. Histological scores and immune cell composition in the heart were similar between genotypes in both C57BL/6 and A/J backgrounds. Echocardiography confirmed functional impairment following CVB3 infection but revealed no significant genotype-dependent differences in cardiac performance. Inflammatory cytokine expression was largely unaffected by enhanced ISGylation, with only minor differences observed.

Conclusion: While ISGylation is critical for antiviral protection in CVB3 infection, selective inactivation of USP18 isopeptidase activity does not mitigate myocardial inflammation or dysfunction during established CVB3 myocarditis. These findings suggest that therapeutic enhancement of ISGylation alone may be insufficient to control inflammation-driven cardiac damage in this model.