Immune Cell-Mediated Inflammation in Heart Failure: Subset Heterogeneity and Targeted Therapy

Area of Science:

• Cardiovascular Medicine
• Immunology
• Translational Research

Background:

• Heart failure (HF) affects over 64 million globally, with current therapies showing limited success, especially in HF with preserved ejection fraction (HFpEF).
• Persistent low-grade sterile inflammation orchestrated by immune cells is a critical factor in HF pathogenesis and progression.
• The intricate cardiac immune microenvironment and immune cell heterogeneity present challenges and opportunities for targeted immunotherapy.

Purpose of the Study:

• To systematically review the heterogeneity, functional characteristics, and interaction networks of key immune cell subpopulations in HF.
• To summarize the current progress in targeted immunotherapies for HF based on immune cell heterogeneity.
• To provide academic references for basic research and clinical translation in HF immunotherapy.

Main Methods:

• Systematic literature review of studies published on PubMed from 2021 to 2026.
• Analysis of immune cell heterogeneity, functional transitions, and interaction networks in HF.
• Summary of therapeutic strategies targeting immune cells in HF.

Main Results:

• Detailed characterization of heterogeneity and functional transitions in macrophages, T cells, neutrophils, and dendritic cells within the HF context.
• Dissection of immune cell interactions with cardiac cells (cardiomyocytes, fibroblasts) and the immune-adipose-heart axis.
• Comprehensive summary of recent advancements in small-molecule drugs, biological agents, and novel immunotherapies for HF.

Conclusions:

• Immune cell heterogeneity is central to HF pathophysiology and presents a promising target for novel therapies.
• Understanding immune cell interactions and cross-organ regulatory mechanisms is crucial for developing effective treatments.
• Future research should focus on spatiotemporal immune dynamics, precise targeting, and individualized immune strategies for HF management.