Cocco Giuseppe, Jerie Paul, Amiet Philipp, Pandolfi Stefano
a Cardiology Office , Rheinfelden , Switzerland.
b Medical Office , Switzerland.
Expert Opin Pharmacother. 2017 Aug;18(12):1225-1233. doi: 10.1080/14656566.2017.1351948. Epub 2017 Jul 20.
The review deals with inflammation in heart failure (HF). Many data show that systemic inflammation is frequent in HF and implicate that inflammation contributes to damage and dysfunction of the cardiovascular system. Areas Covered: Experimental data have been mainly obtained in acute laboratory animal models. It is questionable whether animals' data can be translated into clinical settings with patients with chronic HF who have concomitant pathologies. The idea of a common inflammatory pathway that characterizes all different forms of clinical HF is unrealistic. It seems realistic that inflammation differs in non-cardiac and cardiac diseases. Research therapeutic options address the use of inhibitors of cytokines, of agents antagonizing oxidative stress, of MMP and of PI3K signaling pathways. Expert Opinion: Considering the many unknowns in our knowledge it is not surprising that early trials aimed to antagonize inflammation in HF have been disappointing. We are far away from having solid therapeutic schedules to use immunomodulation in all subtypes of HF. However, modern trials on HF due to virus infections have proven that immunomodulation is therapeutically effective. We should wisely use the known facts and accept that we have many unknowns. By appropriate selection of the subtypes of HF we may be able to find the appropriate therapy against inflammation in HF.
本综述探讨了心力衰竭（HF）中的炎症。许多数据表明，全身炎症在HF中很常见，并暗示炎症会导致心血管系统的损伤和功能障碍。涵盖领域：实验数据主要来自急性实验室动物模型。动物数据能否转化为患有慢性HF且伴有其他病症的患者的临床情况，这是值得怀疑的。认为存在一种共同的炎症途径来表征所有不同形式的临床HF的想法是不现实的。炎症在非心脏疾病和心脏疾病中有所不同，这似乎是现实的。研究治疗选择涉及使用细胞因子抑制剂、拮抗氧化应激的药物、MMP和PI3K信号通路的抑制剂。专家意见：鉴于我们知识中存在许多未知因素，早期旨在拮抗HF中炎症的试验令人失望也就不足为奇了。我们距离拥有在所有HF亚型中使用免疫调节的可靠治疗方案还很遥远。然而，针对病毒感染导致的HF的现代试验已证明免疫调节具有治疗效果。我们应该明智地利用已知事实，并承认我们还有许多未知因素。通过适当选择HF的亚型，我们或许能够找到针对HF中炎症的合适治疗方法。
