Sanmarco Liliana Maria, Eberhardt Natalia, Ponce Nicolás Eric, Cano Roxana Carolina, Bonacci Gustavo, Aoki Maria Pilar
Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina.
Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Córdoba, Argentina.
Front Immunol. 2018 Jan 9;8:1921. doi: 10.3389/fimmu.2017.01921. eCollection 2017.
Macrophages are the primary immune cells that reside within the myocardium, suggesting that these mononuclear phagocytes are essential in the orchestration of cardiac immunity and homeostasis. Independent of the nature of the injury, the heart triggers leukocyte activation and recruitment. However, inflammation is harmful to this vital terminally differentiated organ with extremely poor regenerative capacity. As such, cardiac tissue has evolved particular strategies to increase the stress tolerance and minimize the impact of inflammation. In this sense, growing evidences show that mononuclear phagocytic cells are particularly dynamic during cardiac inflammation or infection and would actively participate in tissue repair and functional recovery. They respond to soluble mediators such as metabolites or cytokines, which play central roles in the timing of the intrinsic cardiac stress response. During myocardial infarction two distinct phases of monocyte influx have been identified. Upon infarction, the heart modulates its chemokine expression profile that sequentially and actively recruits inflammatory monocytes, first, and healing monocytes, later. In the same way, a sudden switch from inflammatory macrophages (with microbicidal effectors) toward anti-inflammatory macrophages occurs within the myocardium very shortly after infection with , the causal agent of Chagas cardiomyopathy. While in sterile injury, healing response is necessary to stop tissue damage; during an intracellular infection, the anti-inflammatory milieu in infected hearts would promote microbial persistence. The balance of mononuclear phagocytic cells seems to be also dynamic in atherosclerosis influencing plaque initiation and fate. This review summarizes the participation of mononuclear phagocyte system in cardiovascular diseases, keeping in mind that the immune system evolved to promote the reestablishment of tissue homeostasis following infection/injury, and that the effects of different mediators could modulate the magnitude and quality of the immune response. The knowledge of the effects triggered by diverse mediators would serve to identify new therapeutic targets in different cardiovascular pathologies.
巨噬细胞是驻留在心肌内的主要免疫细胞，这表明这些单核吞噬细胞在心脏免疫和内环境稳态的协调中至关重要。无论损伤的性质如何，心脏都会触发白细胞的激活和募集。然而，炎症对这个具有极低再生能力的终末分化重要器官是有害的。因此，心脏组织已经进化出特定的策略来提高应激耐受性并最小化炎症的影响。从这个意义上说，越来越多的证据表明，单核吞噬细胞在心脏炎症或感染期间特别活跃，并会积极参与组织修复和功能恢复。它们对可溶性介质如代谢产物或细胞因子作出反应，这些介质在心脏内在应激反应的时机中起核心作用。在心肌梗死期间，已确定单核细胞流入有两个不同阶段。梗死发生后，心脏调节其趋化因子表达谱，首先依次并主动募集炎性单核细胞，随后募集愈合单核细胞。同样，在感染恰加斯心肌病病原体后不久，心肌内会迅速发生从炎性巨噬细胞（具有杀菌效应物）向抗炎巨噬细胞的突然转变。在无菌性损伤中，愈合反应对于阻止组织损伤是必要的；而在细胞内感染期间，受感染心脏中的抗炎环境会促进微生物持续存在。单核吞噬细胞的平衡在动脉粥样硬化中似乎也很动态，影响斑块的起始和转归。本综述总结了单核吞噬细胞系统在心血管疾病中的参与情况，同时牢记免疫系统的进化是为了促进感染/损伤后组织内环境稳态的重建，并且不同介质的作用可以调节免疫反应的程度和质量。了解不同介质引发的效应将有助于确定不同心血管疾病中的新治疗靶点。
