Electroimmunology and cardiac arrhythmia
Jana Grune1,2, Masahiro Yamazoe1,2, Matthias Nahrendorf3,4,5,6
1Center for Systems Biology, Massachusetts General Hospital Research Institute, Harvard Medical School, Boston, MA, USA.
Insights
Cardiac immune cells, like leukocytes, can directly influence heart rhythm and conduction. Understanding these inflammatory roles offers new therapeutic targets for treating arrhythmias.
Area of Science:
- Cardiovascular Electrophysiology
- Immunology
- Cardiac Arrhythmia Pathophysiology
Background:
- Arrhythmias are increasingly prevalent, linked to aging and obesity.
- Inflammation is a known factor in conditions causing arrhythmias, such as atrial fibrillation and heart failure.
- Cardiac immune cells, particularly leukocytes, are now recognized for their direct role in promoting arrhythmias.
Purpose of the Study:
- To review the electrophysiological properties of leukocytes in the heart.
- To explore how leukocytes interact with cardiomyocytes and affect cardiac conduction.
- To draw parallels between immune cell and neural system interactions for information transfer.
Main Methods:
- Literature review synthesizing findings from electrophysiology, immunology, and neuroscience.
- Analysis of the arrhythmogenic potential of leukocytes.
- Extrapolation of neuro-immune interaction principles to cardiac contexts.
Main Results:
- Leukocytes possess electrophysiological properties that can alter cardiac tissue and cardiomyocyte function.
- Immune cells can directly interfere with cardiac electrical conduction.
- Interactions between immune and neural systems offer insights into cardiac information transfer.
Conclusions:
- Leukocytes are not merely epiphenomena but active participants in arrhythmia development.
- Bridging electrophysiology and immunology is crucial for understanding and treating cardiac conduction disorders.
- Further research into immune cell-cardiomyocyte interactions holds promise for novel therapeutic strategies.
Abstract:
Conduction disorders and arrhythmias remain difficult to treat and are increasingly prevalent owing to the increasing age and body mass of the general population, because both are risk factors for arrhythmia. Many of the underlying conditions that give rise to arrhythmia - including atrial fibrillation and ventricular arrhythmia, which frequently occur in patients with acute myocardial ischaemia or heart failure - can have an inflammatory component. In the past, inflammation was viewed mostly as an epiphenomenon associated with arrhythmia; however, the recently discovered inflammatory and non-canonical functions of cardiac immune cells indicate that leukocytes can be arrhythmogenic either by altering tissue composition or by interacting with cardiomyocytes; for example, by changing their phenotype or perhaps even by directly interfering with conduction. In this Review, we discuss the electrophysiological properties of leukocytes and how these cells relate to conduction in the heart. Given the thematic parallels, we also summarize the interactions between immune cells and neural systems that influence information transfer, extrapolating findings from the field of neuroscience to the heart and defining common themes. We aim to bridge the knowledge gap between electrophysiology and immunology, to promote conceptual connections between these two fields and to explore promising opportunities for future research.
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