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[Neuroimmunoendocrine interaction in the pathogenesis of chronic heart failure]
A S Poskrebysheva1, V V Grinevich, Iu V Smurova
1Russian State Medical University, Russian Research Endocrinology Center RAMS, Institute of General Pathology and Pathological Physiology RAMS, Moscow.
Insights
Chronic heart failure (CHF) involves immune system inflammation. This review explores how inflammatory cytokines contribute to CHF, discussing new therapies targeting immune and neurohormonal pathways for better patient outcomes.
Area of Science:
- Cardiology
- Immunology
- Pathophysiology
Context:
- Chronic heart failure (CHF) significantly reduces life expectancy despite advanced treatments.
- Current neurohormonal therapies for CHF remain largely unsatisfactory.
- Emerging research highlights the critical role of immune mechanisms in CHF pathogenesis.
Purpose:
- To review the contribution of inflammatory cytokines to the pathogenesis of chronic heart failure.
- To examine the sources, sites of action, and interactions of cytokines within the neuroendocrine system in CHF.
- To discuss novel therapeutic strategies that address both immune and neurohormonal imbalances in CHF patients.
Summary:
- Inflammatory cytokines, both pro-inflammatory and anti-inflammatory, play a significant role in the development and progression of CHF.
- Cytokine activity is intricately linked with neuroendocrine system dysregulation in the context of CHF.
- Understanding these complex interactions is crucial for developing effective CHF treatments.
Impact:
- Provides a comprehensive overview of the immune basis of CHF, consolidating current research.
- Highlights the limitations of existing neurohormonal treatments and suggests new therapeutic avenues.
- Emphasizes the potential of immunomodulatory and neuroendocrine-targeting therapies to improve outcomes for CHF patients.
Abstract:
Chronic heart failure (CHF) is a common complication of patients with heart dysfunction and of those suffering from various chronic illnesses. Although recently developed therapies revolutionized treatment of CHF, life expectancy of the survivors is still significantly reduced. Proposed neurohoromonal approach in CHF treatment is on the whole rather unsatisfactory. Recently the interest of clinical investigators has been focused on immune mechanisms in the pathogenesis of CHF. In this review we tried to summarize data concerning contribution of inflammatory cytokines to pathogenesis of CHF. The source and site of action of pro- and antiinflammatory cytokines and number of interactions among cytokines and neuroendocrine systems under CHF are considered. Finally we discuss novel therapies managing correction of both immune and neurohormonal status of the patient.