Immune Modulation in Heart Failure: the Promise of Novel Biologics

被引:16
作者
Alvarez P. [1 ]
Briasoulis A. [1 ]
机构
[1] Department of Medicine, Division of Cardiovascular Diseases, Section of Heart Failure and Transplant, University of Iowa, 200 Hawkins Dr, Iowa City, 52242, IA
关键词
Heart failure; Immunomodulation; Inflammation;
D O I
10.1007/s11936-018-0617-z
中图分类号
学科分类号
摘要
Purpose of review: Immune system activation plays a central role in heart failure progression. Large-scale immune modulatory clinical trials targeting tumor necrosis factor-α and broad spectrum immune modulation have been negative. The objective of this review is to highlight past, present, and what is in the horizon for the immunomodulation in heart failure with a focus of biologics. Recent findings: Strategies targeting interleukin-1 pathway are currently undergoing clinical evaluation and data from pilot studies are promising. The potential of cell therapy for immune modulation is increasingly recognized in clinical trials. Strategies targeting anti-cardiac antibodies such as immunoadsorption and intravenous immunoglobulin have been used in clinical practice with positive outcomes but large pragmatic clinical trials are lacking. The use of an aptamer to block anti-cardiac antibodies is undergoing phase 1 clinical evaluation. Promising targets include inflammasomes, toll-like receptors, chemokines, natural killer cells, and macrophages. Summary: Large-scale immune modulatory clinical trials have been negative. Nevertheless, the experience gained from them along with increasing understanding of molecular mechanisms of immune pathophysiology in heart failure is leading to rapid recognition of new therapeutic targets and approaches. © 2018, Springer Science+Business Media, LLC, part of Springer Nature.
引用
收藏
相关论文
共 79 条
[1]  
Arutyunov G.P., Kostyukevich O.I., Serov R.A., Rylova N.V., Bylova N.A., Collagen accumulation and dysfunctional mucosal barrier of the small intestine in patients with chronic heart failure, Int J Cardiol, 125, 2, pp. 240-245, (2008)
[2]  
Kitai T., Kirsop J., Tang W.H., Exploring the microbiome in heart failure, Curr Heart Fail Rep, 13, 2, pp. 103-109, (2016)
[3]  
Sager H.B., Kessler T., Schunkert H., Monocytes and macrophages in cardiac injury and repair, J Thorac Dis, 9, pp. S30-S35, (2017)
[4]  
Tracchi I., Ghigliotti G., Mura M., Garibaldi S., Spallarossa P., Barisione C., Boasi V., Brunelli M., Corsiglia L., Barsotti A., Brunelli C., Increased neutrophil lifespan in patients with congestive heart failure, Eur J Heart Fail, 11, 4, pp. 378-385, (2009)
[5]  
Levick S.P., Melendez G.C., Plante E., McLarty J.L., Brower G.L., Janicki J.S., Cardiac mast cells: the centrepiece in adverse myocardial remodelling, Cardiovasc Res, 89, 1, pp. 12-19, (2011)
[6]  
Sugi Y., Yasukawa H., Kai H., Fukui D., Futamata N., Mawatari K., Oba T., Nagata N., Kyougoku S., Koga M., Imaizumi T., Reduction and activation of circulating dendritic cells in patients with decompensated heart failure, Int J Cardiol, 147, 2, pp. 258-264, (2011)
[7]  
Vredevoe D.L., Widawski M., Fonarow G.C., Hamilton M., Martinez-Maza O., Gage J.R., Interleukin-6 (IL-6) expression and natural killer (NK) cell dysfunction and anergy in heart failure, Am J Cardiol, 93, 8, pp. 1007-1011, (2004)
[8]  
Clark D.J., Cleman M.W., Pfau S.E., Rollins S.A., Ramahi T.M., Mayer C., Caulin-Glaser T., Daher E., Kosiborod M., Bell L., Setaro J.F., Serum complement activation in congestive heart failure, Am Heart J, 141, 4, pp. 684-690, (2001)
[9]  
Levine B., Kalman J., Mayer L., Fillit H.M., Packer M., Elevated circulating levels of tumor necrosis factor in severe chronic heart failure, N Engl J Med, 323, 4, pp. 236-241, (1990)
[10]  
Naftali-Shani N., Levin-Kotler L.P., Palevski D., Amit U., Kain D., Landa N., Hochhauser E., Leor J., <span hwp:id="article-title-1" class="article-title">Left ventricular dysfunction switches mesenchymal stromal cells toward an inflammatory phenotype and impairs their reparative properties via toll-like receptor-4</span><span hwp:id="article-title-48" class="sub-article-title">clinical perspective</span>, Circulation, 135, 23, pp. 2271-2287, (2017)