Abstract

Pressure overload and heart failure are among the leading causes of cardiovascular morbidity and mortality. Accumulating evidence suggests that inflammatory cell activation and release of inflammatory mediators are of vital importance during the pathogenesis of these cardiac diseases. Yet, the roles of innate immune cells and subsequent inflammatory events in these processes remain poorly understood. Here, we outline the possible underlying mechanisms of innate immune cell participation, including mast cells, macrophages, monocytes, neutrophils, dendritic cells, eosinophils, and natural killer T cells in these pathological processes. Although these cells accumulate in the atrium or ventricles at different time points after pressure overload, their cardioprotective or cardiodestructive activities differ from each other. Among them, mast cells, neutrophils, and dendritic cells exert detrimental function in experimental models, whereas eosinophils and natural killer T cells display cardioprotective activities. Depending on their subsets, macrophages and monocytes may exacerbate cardiodysfunction or negatively regulate cardiac hypertrophy and remodeling. Pressure overload stimulates the secretion of cytokines, chemokines, and growth factors from innate immune cells and even resident cardiomyocytes that together assist innate immune cell infiltration into injured heart. These infiltrates are involved in pro-hypertrophic events and cardiac fibroblast activation. Immune regulation of cardiac innate immune cells becomes a promising therapeutic approach in experimental cardiac disease treatment, highlighting the significance of their clinical evaluation in humans.

Highlights

  • Pressure overload refers to the left ventricular (LV) pressure overload caused by aortic stenosis, hypertension, and coarctation of the aorta, and right ventricular (RV) pressure overload triggered by pulmonary stenosis and pulmonary hypertension, leading to cardiac hypertrophy and fibrosis (Berk et al, 2007)

  • In transverse aortic constriction (TAC)-induced mouse hypertrophic hearts, FACS analysis showed that the CD206+ or CD206− macrophages or CD11b+F4/80+MHCII+ macrophages peaked at 6–7 days after TAC injury in mice (Patel et al, 2017; Figure 1B, upper panel)

  • Mast cells were first linked to cardiac fibrosis more than 50 years ago following the observation that these cells accumulated in the endocardial fibrotic region from an autopsy series of 672 cases (Fernex and Sternby, 1964)

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Summary

INTRODUCTION

Pressure overload refers to the left ventricular (LV) pressure overload caused by aortic stenosis, hypertension, and coarctation of the aorta, and right ventricular (RV) pressure overload triggered by pulmonary stenosis and pulmonary hypertension, leading to cardiac hypertrophy and fibrosis (Berk et al, 2007) Such remodeling exhibits extensive morphological changes, including cardiomyocyte mass increase, sarcomere rearrangement, and extracellular matrix (ECM) deposition in cardiac interstitial or perivascular regions (Schiattarella and Hill, 2015). Activated immune cells produce high levels of cytokines that induce cardiomyocyte hypertrophy, such as TNF-α, IL1β, and IL6. The murine model of pulmonary artery constriction (PAC) generates RV hypertrophy and fibrosis following pulmonary artery hypertension (Braun et al, 2003) Another model that mimics pressure overload is aldosterone analog deoxycorticosterone acetate (DOCA) accompanied by unilateral nephrectomy and high-salt diet. Pressure overload-induced hypertrophy in experimental animals displayed enhanced systolic and diastolic blood pressures, increased cardiac mass, and eventually elevated cardiac fibrosis

Innate Immune Cells
MAST CELLS
MC Molecular and Cellular Mechanisms
Therapeutic Potential of Targeting MCs
MONOCYTES AND MACROPHAGES
Molecular and Cellular Mechanisms of Monocyte and Macrophage Actions
Therapies by Targeting Monocytes and Macrophages
Mechanisms of Neutrophil Action
DENDRITIC CELLS
Mechanisms of DC Function
Findings
CONCLUSION AND FUTURE PROSPECTS
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