Department of Nephrology, Medical School, University of Ioannina, Ioannina, Greece.
2nd Department of Cardiology, Medical School, University of Ioannina, Ioannina, Greece.
Curr Vasc Pharmacol. 2021;19(1):63-76. doi: 10.2174/1570161118666200628024027.
Adverse innate immune responses have been implicated in several disease processes, including cardiovascular disease (CVD) and chronic kidney disease (CKD). The monocyte subsets natural killer (NK) cells and natural killer T (NKT) cells are involved in innate immunity. Monocytes subsets are key in atherogenesis and the inflammatory cascade occurring in heart failure. Upregulated activity and counts of proinflammatory CD16+ monocyte subsets are associated with clinical indices of atherosclerosis, heart failure syndromes and CKD. Advanced CKD is a complex state of persistent systemic inflammation characterized by elevated expression of proinflammatory and pro-atherogenic CD14++CD16+ monocytes, which are associated with cardiovascular events and death both in the general population and among patients with CKD. Diminished NK cells and NKT cells counts and aberrant activity are observed in both coronary artery disease and end-stage kidney disease. However, evidence of the roles of NK cells and NKT cells in atherogenesis in advanced CKD is circumstantial and remains to be clarified. This review describes the available evidence regarding the roles of specific immune cell subsets in the pathogenesis of CVD in patients with CKD. Future research is expected to further uncover the links between CKD associated innate immune system dysregulation and accelerated CVD and will ideally be translated into therapeutic targets.
先天免疫应答异常与多种疾病过程有关，包括心血管疾病（CVD）和慢性肾病（CKD）。单核细胞亚群自然杀伤（NK）细胞和自然杀伤 T（NKT）细胞参与先天免疫。单核细胞亚群在动脉粥样硬化形成和心力衰竭发生的炎症级联反应中起关键作用。促炎 CD16+单核细胞亚群的活性和计数增加与动脉粥样硬化、心力衰竭综合征和 CKD 的临床指标相关。晚期 CKD 是一种持续全身炎症的复杂状态，其特征是促炎和促动脉粥样硬化的 CD14++CD16+单核细胞表达升高，这与普通人群和 CKD 患者的心血管事件和死亡相关。在冠状动脉疾病和终末期肾病中均观察到 NK 细胞和 NKT 细胞计数减少和功能异常。然而，NK 细胞和 NKT 细胞在晚期 CKD 中动脉粥样硬化形成中的作用的证据只是间接的，仍有待阐明。本综述描述了关于特定免疫细胞亚群在 CKD 患者 CVD 发病机制中的作用的现有证据。预计未来的研究将进一步揭示 CKD 相关先天免疫系统失调与加速 CVD 之间的联系，并有望转化为治疗靶点。
