Reappraising the role of inflammation in heart failure
Top Cited Papers
- 30 April 2020
- journal article
- review article
- Published by Springer Science and Business Media LLC in Nature Reviews Cardiology
- Vol. 17 (5), 269-285
- https://doi.org/10.1038/s41569-019-0315-x
Abstract
Inflammation has an important role in the pathogenesis of acute and chronic heart failure. This Review summarizes the latest findings on the role of the innate and adaptive immune systems in the pathogenesis of heart failure, and highlights the results of phase III clinical trials of therapies targeting inflammatory processes in this condition, such as anti-inflammatory and immunomodulatory strategies. The observation that heart failure with reduced ejection fraction is associated with elevated circulating levels of pro-inflammatory cytokines opened a new area of research that has revealed a potentially important role for the immune system in the pathogenesis of heart failure. However, until the publication in 2019 of the CANTOS trial findings on heart failure outcomes, all attempts to target inflammation in the heart failure setting in phase III clinical trials resulted in neutral effects or worsening of clinical outcomes. This lack of positive results in turn prompted questions on whether inflammation is a cause or consequence of heart failure. This Review summarizes the latest developments in our understanding of the role of the innate and adaptive immune systems in the pathogenesis of heart failure, and highlights the results of phase III clinical trials of therapies targeting inflammatory processes in the heart failure setting, such as anti-inflammatory and immunomodulatory strategies. The most recent of these studies, the CANTOS trial, raises the exciting possibility that, in the foreseeable future, we might be able to identify those patients with heart failure who have a cardio-inflammatory phenotype and will thus benefit from therapies targeting inflammation.Keywords
This publication has 156 references indexed in Scilit:
- The inflammasome promotes adverse cardiac remodeling following acute myocardial infarction in the mouseProceedings of the National Academy of Sciences of the United States of America, 2011
- Therapeutic siRNA silencing in inflammatory monocytes in miceNature Biotechnology, 2011
- The Emerging Role of Innate Immunity in the Heart and Vascular SystemCirculation Research, 2011
- Innate or Adaptive Immunity? The Example of Natural Killer CellsScience, 2011
- Cardiac mast cells: the centrepiece in adverse myocardial remodellingCardiovascular Research, 2010
- Characterization of the inflammatory and fibrotic response in a mouse model of cardiac pressure overloadHistochemistry and Cell Biology, 2008
- Effect of rosuvastatin in patients with chronic heart failure (the GISSI-HF trial): a randomised, double-blind, placebo-controlled trialThe Lancet, 2008
- Effect of n-3 polyunsaturated fatty acids in patients with chronic heart failure (the GISSI-HF trial): a randomised, double-blind, placebo-controlled trialThe Lancet, 2008
- How regulatory T cells workNature Reviews Immunology, 2008
- The Foxp3+ regulatory T cell: a jack of all trades, master of regulationNature Immunology, 2008