Trained Immunity in Interorgan Communication and Vascular Inflammation

Area of Science:

• Immunology
• Cardiovascular Medicine
• Metabolic Disease Research

Background:

• Patients surviving ischemic stroke or myocardial infarction have a high risk of long-term cardiovascular and metabolic issues.
• Trained immunity, a form of innate immune memory, is increasingly recognized as a key factor in these comorbidities.

Purpose of the Study:

• To explore the role of trained immunity in mediating interorgan communication after ischemic events.
• To understand how trained immunity contributes to the development of multimorbidity in vascular patients.
• To discuss potential therapeutic strategies targeting innate immune memory.

Main Methods:

• Review of emerging evidence on trained immunity and its impact on hematopoietic progenitors.
• Analysis of mechanisms linking sterile insults (stroke, myocardial infarction) to persistent inflammatory memory.
• Conceptual framework development for understanding systemic immune circuits.

Main Results:

• Ischemic events induce trained immunity by reprogramming bone marrow progenitors, leading to sustained inflammation.
• This reprogramming biases myelopoiesis, generating proinflammatory monocytes that affect distant organs.
• Trained immunity links single ischemic events to cardiac dysfunction, accelerated atherosclerosis, and metabolic exacerbation.

Conclusions:

• Trained immunity is a central mechanism explaining multimorbidity after ischemic events.
• Understanding these immune circuits offers a framework for novel therapeutic interventions.
• Targeting maladaptive innate immune memory may mitigate chronic vascular inflammation and disease.