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  • Review Article
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Role of innate and adaptive immune mechanisms in cardiac injury and repair

Nature Reviews Immunology volume 15, pages 117–129 (2015)Cite this article

Subjects

Key Points

  • Cardiac injury can lead to cardiomyocyte death, intense inflammation, scar formation and, over time, adverse cardiac remodelling.

  • Following injury, cardiac inflammation is triggered by the release of conserved endogenous molecules and the production of pro-inflammatory cytokines and chemokines that lead to cellular infiltration.

  • Early activation of mast cells leads to neutrophil recruitment, a robust inflammatory response and tissue damage.

  • Recruited monocytes and resident macrophages modulate both tissue injury and tissue healing.

  • Macrophage origin may dictate function in the heart. Primitive embryonically derived macrophages mediate cardiac tissue repair, whereas bone marrow-derived monocytes contribute to inflammation following cardiac injury.

  • Lymphocytes and macrophages are involved in the complex transition from initial cardiac tissue inflammation to wound healing.

Abstract

Despite the advances that have been made in developing new therapeutics, cardiovascular disease remains the leading cause of worldwide mortality. Therefore, understanding the mechanisms underlying cardiovascular tissue injury and repair is of prime importance. Following cardiac tissue injury, the immune system has an important and complex role in driving both the acute inflammatory response and the regenerative response. This Review summarizes the role of the immune system in cardiovascular disease — focusing on the idea that the immune system evolved to promote tissue homeostasis following injury and/or infection, and that the inherent cost of this evolutionary development is unwanted inflammatory damage.

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Figure 1: Immune cells in the resting heart.
Figure 2: Cardiac injury and sensing damaged tissue.
Figure 3: Immune response to ischaemic injury in adult animals.
Figure 4: Role of embryonically derived macrophages during tissue injury and repair.
Figure 5: Interaction of coxsackievirus B with the host innate and acquired immune system.

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Authors and Affiliations

  1. Toronto Medical Discovery Tower, 101 College Street, TMDT 3903 Toronto, Ontario, M5G 1L7, Canada

    Slava Epelman

  2. University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, K1Y 4W7, Ontario, Canada

    Peter P. Liu

  3. Division of Cardiology, Department of Medicine, Center for Cardiovascular Research, Washington University School of Medicine, St. Louis, 63110, Missouri, USA

    Douglas L. Mann

Authors
  1. Slava Epelman
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  2. Peter P. Liu
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  3. Douglas L. Mann
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Correspondence to Slava Epelman.

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Epelman, S., Liu, P. & Mann, D. Role of innate and adaptive immune mechanisms in cardiac injury and repair. Nat Rev Immunol 15, 117–129 (2015). https://doi.org/10.1038/nri3800

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