Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Panahi, M; Papanikolaou, A; Torabi, A; Zhang, JG; Khan, H; Vazir, A; Hasham, MG; Cleland, JGF; Rosenthal, NA; Harding, SE; Sattler, S.
Immunomodulatory interventions in myocardial infarction and heart failure: a systematic review of clinical trials and meta-analysis of IL-1 inhibition.
Cardiovasc Res. 2018; 114(11): 1445-1461.
Doi: 10.1093/cvr/cvy145
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- Führende Autor*innen der Med Uni Graz
- Sattler Susanne
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- Abstract:
- Following a myocardial infarction (MI), the immune system helps to repair ischaemic damage and restore tissue integrity, but excessive inflammation has been implicated in adverse cardiac remodelling and development towards heart failure (HF). Pre-clinical studies suggest that timely resolution of inflammation may help prevent HF development and progression. Therapeutic attempts to prevent excessive post-MI inflammation in patients have included pharmacological interventions ranging from broad immunosuppression to immunomodulatory approaches targeting specific cell types or factors with the aim to maintain beneficial aspects of the early post-MI immune response. These include the blockade of early initiators of inflammation including reactive oxygen species and complement, inhibition of mast cell degranulation and leucocyte infiltration, blockade of inflammatory cytokines, and inhibition of adaptive B and T-lymphocytes. Herein, we provide a systematic review on post-MI immunomodulation trials and a meta-analysis of studies targeting the inflammatory cytokine Interleukin-1. Despite an enormous effort into a significant number of clinical trials on a variety of targets, a striking heterogeneity in study population, timing and type of treatment, and highly variable endpoints limits the possibility for meaningful meta-analyses. To conclude, we highlight critical considerations for future studies including (i) the therapeutic window of opportunity, (ii) immunological effects of routine post-MI medication, (iii) stratification of the highly diverse post-MI patient population, (iv) the potential benefits of combining immunomodulatory with regenerative therapies, and at last (v) the potential side effects of immunotherapies.
- Find related publications in this database (using NLM MeSH Indexing)
- Anti-Inflammatory Agents - adverse effects, therapeutic use
- Clinical Trials as Topic - administration & dosage
- Heart Failure - drug therapy, immunology, metabolism
- Humans - administration & dosage
- Immunosuppressive Agents - adverse effects, therapeutic use
- Inflammation Mediators - antagonists & inhibitors, immunology, metabolism
- Interleukin-1 - antagonists & inhibitors, immunology, metabolism
- Myocardial Infarction - drug therapy, immunology, metabolism
- Risk Factors - administration & dosage
- Signal Transduction - drug effects
- Treatment Outcome - administration & dosage
- Find related publications in this database (Keywords)
- Immunomodulation
- Immunotherapy
- Myocardial infarction
- Heart failure
- IL-1 inhibition
- Systematic review