School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
Expert Rev Clin Immunol. 2023 Jun;19(6):585-597. doi: 10.1080/1744666X.2023.2196013. Epub 2023 Mar 31.
Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia. Moreover, it is mentioned as one of the important causes of death due to heart disease, which imposes an undeniable financial burden on public health systems. Almost 1 out of 4 individuals aged 40 to 55 will experience AF at some point during their life. Increasing the pressure or the volume of the atria over time leads to the activation of fibroblasts, resulting in the accumulation of extracellular matrix and fibrosis. By disturbing electrical conduction, fibrosis creates microreentrant circuits, which can develop into AF.
In this article, we evaluated the vital role of interleukins and inflammatory mediators in the pathogenesis, prognosis, and treatment of AF. We also discussed the importance of the broader use of interleukins in the clinical management of AF patients.
Interleukins and inflammatory markers can be used as markers of diagnosis, cardiovascular events, and mortality in AF patients. Finally, the utilization of substances upregulating IL-10, such as resolvin D1 (RvD1), or applying IL-6 down-regulators and inhibitors, including anti-IL-6 antibodies, colchicine, and C1q/tumor necrosis factor-related protein-9 (CTRP9), are effective in the reduction of atrial interstitial fibrosis and treating AF patients.
心房颤动(AF)是最常见的心律失常。此外,它被认为是心脏病死亡的重要原因之一,这给公共卫生系统带来了不可忽视的经济负担。几乎每 4 个 40 至 55 岁的人中就有 1 人会在其一生中的某个时刻经历 AF。随着时间的推移,心房压力或容量的增加会导致成纤维细胞的激活,导致细胞外基质的积累和纤维化。纤维化通过干扰电传导,形成微折返环,从而可能发展为 AF。
在本文中,我们评估了白细胞介素和炎症介质在 AF 的发病机制、预后和治疗中的重要作用。我们还讨论了在 AF 患者的临床管理中更广泛地使用白细胞介素的重要性。
白细胞介素和炎症标志物可作为 AF 患者诊断、心血管事件和死亡率的标志物。最后,使用上调白细胞介素 10 的物质,如解析素 D1(RvD1),或应用白细胞介素 6 下调剂和抑制剂,包括抗白细胞介素 6 抗体、秋水仙碱和 C1q/肿瘤坏死因子相关蛋白 9(CTRP9),可有效减少心房间质纤维化并治疗 AF 患者。