The Innate Immune System and Cardiovascular Disease in ESKD: Monocytes and Natural Killer Cells

Area of Science:

• Immunology
• Nephrology
• Cardiology

Background:

• Adverse innate immune responses are linked to cardiovascular disease (CVD) and chronic kidney disease (CKD).
• Monocyte subsets, natural killer (NK) cells, and natural killer T (NKT) cells are key players in innate immunity.
• Proinflammatory CD16+ monocyte subsets are associated with atherosclerosis, heart failure, and CKD progression.

Purpose of the Study:

• To review the evidence on the roles of specific innate immune cell subsets in the pathogenesis of CVD in patients with CKD.
• To clarify the roles of NK and NKT cells in atherogenesis within advanced CKD.
• To highlight the link between CKD-associated immune dysregulation and accelerated CVD.

Main Methods:

• Literature review of existing evidence.
• Analysis of studies investigating immune cell subsets in CVD and CKD.
• Synthesis of findings on monocyte, NK, and NKT cell involvement.

Main Results:

• Elevated CD14++CD16+ monocytes are linked to cardiovascular events and mortality in CKD.
• Diminished NK and NKT cell counts and aberrant activity are observed in coronary artery disease and end-stage kidney disease.
• Evidence for NK and NKT cell roles in CKD-associated atherogenesis is currently circumstantial.

Conclusions:

• Innate immune cell dysregulation, particularly involving monocytes, NK, and NKT cells, significantly contributes to CVD pathogenesis in CKD patients.
• Further research is needed to fully elucidate the mechanisms linking CKD-associated immune dysfunction to accelerated CVD.
• Understanding these links may lead to novel therapeutic targets for managing CVD in CKD.