Complement activation and cardiovascular disease
M Bjerre1, T K Hansen, A Flyvbjerg
1The Medical Research Laboratories, Clinical Institute and Immunoendocrine Research Unit, Medical Department M (Diabetes and Endocrinology), Aarhus University Hospital, Aarhus C, Denmark. mette.bjerre@ki.au.dk
Insights
Complement activation contributes to tissue damage after heart attacks. Targeting this system, particularly the lectin pathway, may offer new treatments for cardiovascular diseases and reperfusion injury.
Area of Science:
- Cardiovascular Science
- Immunology
- Pathophysiology
Background:
- Tissue injury following acute myocardial infarction involves complex mechanisms.
- Complement system activation is implicated in the pathophysiology of myocardial infarction and reperfusion injury.
- While essential for immune defense, excessive complement activation can exacerbate tissue damage.
Purpose of the Study:
- To review the role of complement activation in myocardial infarction and associated tissue injury.
- To highlight the significance of the lectin pathway in cardiovascular diseases like ischemic heart disease and diabetic angiopathy.
- To discuss potential therapeutic strategies targeting the complement system.
Main Methods:
- Literature review focusing on complement activation, endothelial dysfunction, and cardiovascular diseases.
- Analysis of the role of the lectin pathway in myocardial reperfusion injury.
- Examination of therapeutic interventions targeting the complement cascade.
Main Results:
- Complement activation plays a dual role, offering protection but also contributing to damage during myocardial reperfusion.
- The lectin pathway is a key mediator in complement-induced cardiovascular pathology.
- Endothelial dysfunction is closely linked to complement activation in cardiovascular diseases.
Conclusions:
- Complement system modulation, especially the lectin pathway, presents a promising therapeutic avenue for myocardial infarction and related conditions.
- Understanding complement's role is crucial for developing effective treatments for ischemic heart disease and diabetic angiopathy.
- Targeting complement activation could mitigate reperfusion injury and improve patient outcomes.
Abstract:
The mechanisms by which tissue injury after acute myocardial infarction occurs have not been fully elucidated, but considerable evidence suggests that activation of complement plays an important role in the pathophysiology. Reperfusion of the ischemic myocardium is strictly necessary to rescue the exposed tissue from eventual death. However, reversion of the blood supply is also associated with reperfusion injury contributing to tissue injury. Activation of the complement system has indisputable beneficial effects in the immune defense and in the clearance of damaged tissue and apoptotic cells, but excessive activation of the system may lead to uncontrolled tissue damage. This review focuses on the role of complement activation, with focus on the lectin pathway, endothelial dysfunction and cardiovascular diseases, including ischemic heart disease and diabetic angiopathy. Finally, potential therapeutic strategies targeting the complement system are discussed.
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