Immune Cells and Immunotherapy for Cardiac Injury and Repair

Circ Res. 2021 May 28;128(11):1766-1779. doi: 10.1161/CIRCRESAHA.121.318005. Epub 2021 May 27.

Abstract

Cardiac injury remains a major cause of morbidity and mortality worldwide. Despite significant advances, a full understanding of why the heart fails to fully recover function after acute injury, and why progressive heart failure frequently ensues, remains elusive. No therapeutics, short of heart transplantation, have emerged to reliably halt or reverse the inexorable progression of heart failure in the majority of patients once it has become clinically evident. To date, most pharmacological interventions have focused on modifying hemodynamics (reducing afterload, controlling blood pressure and blood volume) or on modifying cardiac myocyte function. However, important contributions of the immune system to normal cardiac function and the response to injury have recently emerged as exciting areas of investigation. Therapeutic interventions aimed at harnessing the power of immune cells hold promise for new treatment avenues for cardiac disease. Here, we review the immune response to heart injury, its contribution to cardiac fibrosis, and the potential of immune modifying therapies to affect cardiac repair.

Keywords: fibrosis; heart disease; immunology; immunotherapy.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adaptive Immunity
  • B-Lymphocytes / physiology
  • Bioengineering
  • Cytokines / metabolism
  • Disease Progression
  • Eosinophils / physiology
  • Fibroblasts / physiology
  • Fibrosis
  • Heart Failure / etiology
  • Heart Failure / immunology
  • Heart Failure / therapy*
  • Heart Injuries / immunology
  • Heart Injuries / therapy*
  • Humans
  • Immunotherapy / methods*
  • Immunotherapy, Adoptive
  • Macrophages / physiology
  • Mast Cells / physiology
  • Monocytes / physiology
  • Myocardium / pathology
  • Myocytes, Cardiac / physiology
  • Neutrophils / physiology
  • Receptors, Chimeric Antigen
  • T-Lymphocytes / physiology
  • T-Lymphocytes / transplantation

Substances

  • Cytokines
  • Receptors, Chimeric Antigen