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Inflammation Resolution in the Cardiovascular System: Arterial Hypertension, Atherosclerosis, and Ischemic Heart
Azuah L Gonzalez1,2, Matthew M Dungan1,2, C Duncan Smart3,4
1Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Insights
Failed inflammation resolution drives chronic diseases like cardiovascular conditions. Understanding active resolution mechanisms is key to developing therapies that reduce inflammation without compromising immunity.
Area of Science:
- Immunology
- Cardiovascular Medicine
- Molecular Biology
Background:
- Chronic inflammation is a key factor in Western diseases, including cardiovascular conditions.
- Targeting inflammation offers therapeutic potential but risks infection.
- Inflammation resolution is an active process involving specialized mediators and cell types.
Purpose of the Study:
- To review the role of inflammation resolution in cardiovascular diseases.
- To discuss the mechanisms of failed resolution in disease progression.
- To explore the potential of pro-resolving therapies.
Main Methods:
- Literature review of experimental and clinical studies.
- Analysis of specialized pro-resolving mediators.
- Examination of pro-reparative cell types (T regulatory cells, myeloid-derived suppressor cells, macrophages).
Main Results:
- Failures in producing pro-resolving mediators and clearing dead cells contribute to chronic inflammation.
- Specific pro-resolving mediators and cell types are involved in arterial hypertension, atherosclerosis, myocardial infarction, and ischemic heart disease.
- Active resolution mechanisms are crucial for tissue repair and terminating inflammation.
Conclusions:
- Understanding inflammation resolution is vital for treating chronic inflammatory diseases.
- Pro-resolving therapies could limit inflammation without increasing infection risk.
- Further research into resolution mechanisms is needed to identify therapeutic targets.
Abstract:
Significance: Chronic inflammation has emerged as a major underlying cause of many prevalent conditions in the Western world, including cardiovascular diseases. Although targeting inflammation has emerged as a promising avenue by which to treat cardiovascular disease, it is also associated with increased risk of infection. Recent Advances: Though previously assumed to be passive, resolution has now been identified as an active process, mediated by unique immunoresolving mediators and mechanisms designed to terminate acute inflammation and promote tissue repair. Recent work has determined that failures of resolution contribute to chronic inflammation and the progression of human disease. Specifically, failure to produce pro-resolving mediators and the impaired clearance of dead cells from inflamed tissue have been identified as major mechanisms by which resolution fails in disease. Critical Issues: Drawing from a rapidly expanding body of experimental and clinical studies, we review here what is known about the role of inflammation resolution in arterial hypertension, atherosclerosis, myocardial infarction, and ischemic heart disease. For each, we discuss the involvement of specialized pro-resolving mediators and pro-reparative cell types, including T regulatory cells, myeloid-derived suppressor cells, and macrophages. Future Directions: Pro-resolving therapies offer the promise of limiting chronic inflammation without impairing host defense. Therefore, it is imperative to better understand the mechanisms underlying resolution to identify therapeutic targets. Antioxid. Redox Signal. 40, 292-316.
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