Das Shibali, Lavine Kory J
Center for Cardiovascular Research, Division of Cardiology, Department of Medicine, Washington University School of Medicine, 660 S Euclid Ave, Campus Box 8086, St. Louis, MO, 63110, USA.
Curr Cardiol Rep. 2025 Jan 13;27(1):18. doi: 10.1007/s11886-024-02167-7.
This review aims to explore the role of immune memory and trained immunity, focusing on how innate immune cells like monocytes, macrophages, and natural killer cells undergo long-term epigenetic and metabolic rewiring. Specifically, it examines the mechanisms by which trained immunity, often triggered by infection or vaccination, could impact cardiac processes and contribute to both protective and pathological responses within the cardiovascular system.
Recent research demonstrates that vaccination and infection not only activate immune responses in circulating monocytes and tissue macrophages but also affect immune progenitor cells within the bone marrow environment, conferring lasting protection against heterologous infections. These protective effects are attributed to epigenetic and metabolic reprogramming, which enable a heightened immune response upon subsequent encounters with pathogens. However, while trained immunity is beneficial in combating infections, it has been linked to exacerbated inflammation, which may increase susceptibility to cardiovascular diseases, including atherosclerosis and heart failure. Our review highlights the dual nature of trained immunity: while it offers protective advantages against infections, it also poses potential risks for cardiovascular health by promoting chronic inflammation. Understanding the molecular mechanisms underlying immune memory's impact on cardiac processes could lead to new therapeutic strategies to mitigate cardiovascular diseases, such as atherosclerosis, heart failure, and diabetes. These insights build the grounds for future research to balance the benefits of trained immunity with its potential risks in cardiovascular disease management.
本综述旨在探讨免疫记忆和训练有素的免疫的作用，重点关注单核细胞、巨噬细胞和自然杀伤细胞等固有免疫细胞如何经历长期的表观遗传和代谢重编程。具体而言，它研究了通常由感染或疫苗接种引发的训练有素的免疫可能影响心脏过程并促成心血管系统内保护性和病理性反应的机制。
最近的研究表明，疫苗接种和感染不仅会激活循环单核细胞和组织巨噬细胞中的免疫反应，还会影响骨髓环境中的免疫祖细胞，从而对异源感染提供持久保护。这些保护作用归因于表观遗传和代谢重编程，这使得在随后遇到病原体时能够增强免疫反应。然而，虽然训练有素的免疫在对抗感染方面有益，但它与炎症加剧有关，这可能会增加患心血管疾病的易感性，包括动脉粥样硬化和心力衰竭。我们的综述强调了训练有素的免疫的双重性质：虽然它对感染具有保护优势，但它也通过促进慢性炎症对心血管健康构成潜在风险。了解免疫记忆对心脏过程影响的分子机制可能会导致减轻心血管疾病（如动脉粥样硬化、心力衰竭和糖尿病）的新治疗策略。这些见解为未来研究奠定了基础，以在心血管疾病管理中平衡训练有素的免疫的益处及其潜在风险。
