Department of Internal Medicine I, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany.
Basic Res Cardiol. 2013 Jul;108(4):356. doi: 10.1007/s00395-013-0356-y. Epub 2013 Jun 6.
The prevalence of chronic heart failure is still increasing making it a major health issue in the 21st century. Tremendous evidence has emerged over the past decades that heart failure is associated with a wide array of mechanisms subsumed under the term "inflammation". Based on the great success of immuno-suppressive treatments in auto-immunity and transplantation, clinical trials were launched targeting inflammatory mediators in patients with chronic heart failure. However, they widely lacked positive outcomes. The failure of the initial study program directed against tumor necrosis factor-α led to the search for alternative therapeutic targets involving a broader spectrum of mechanisms besides cytokines. We here provide an overview of the current knowledge on immune activation in chronic heart failure of different etiologies, summarize clinical studies in the field, address unresolved key questions, and highlight some promising novel therapeutic targets for clinical trials from a translational basic science and clinical perspective.
慢性心力衰竭的患病率仍在不断上升，使其成为 21 世纪的主要健康问题。在过去几十年中，出现了大量证据表明心力衰竭与广泛的机制有关，这些机制被归为“炎症”一词之下。基于免疫抑制治疗在自身免疫和移植方面的巨大成功，针对慢性心力衰竭患者的炎症介质的临床试验已经启动。然而，它们广泛缺乏积极的结果。针对肿瘤坏死因子-α的初始研究计划的失败导致人们寻找替代性治疗靶点，这些靶点涉及除细胞因子以外的更广泛的机制。在这里，我们概述了不同病因慢性心力衰竭中免疫激活的最新知识，总结了该领域的临床研究，解决了未解决的关键问题，并从转化基础科学和临床角度强调了一些有前途的新型治疗靶点，供临床试验使用。
