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免疫检查点蛋白PD-1和CTLA-4在导致心力衰竭的心血管并发症中的作用。

The role of immune checkpoints PD-1 and CTLA-4 in cardiovascular complications leading to heart failure.

作者信息

Huang Shoulian, Kang Yu, Liu Ting, Xiong Yan, Yang Zixuan, Zhang Qing

机构信息

Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

Department of Cardiology, The Second People's Hospital of Yibin, Yibin, Sichuan, China.

出版信息

Front Immunol. 2025 Apr 4;16:1561968. doi: 10.3389/fimmu.2025.1561968. eCollection 2025.


DOI:10.3389/fimmu.2025.1561968
PMID:40255399
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12006013/
Abstract

Immune checkpoints, such as PD-1 and CTLA-4, are crucial regulators of immune responses, acting as gatekeepers to balance immunity against foreign antigens and self-tolerance. These checkpoints play a key role in maintaining cardiac homeostasis by preventing immune-mediated damage to critical organs like the heart. In this study, we explored the involvement of PD-1 and CTLA-4 in cardiovascular complications, particularly atherosclerosis and myocarditis, which can lead to heart failure. We conducted a comprehensive analysis using animal models and clinical data to assess the effects of immune checkpoint inhibition on cardiac function. Our findings indicate that disruption of PD-1 and CTLA-4 pathways exacerbates myocardial inflammation, accelerates atherosclerotic plaque formation, and promotes the development of heart failure. Additionally, we observed that immune checkpoint inhibition in these models led to increased infiltration of T lymphocytes, higher levels of pro-inflammatory cytokines, and enhanced tissue damage. These results suggest that PD-1 and CTLA-4 are critical in preserving cardiac health, and their inhibition can result in severe cardiovascular toxicity. Our study emphasizes the need for careful monitoring of cardiovascular health in patients undergoing immune checkpoint inhibitor therapies.

摘要

免疫检查点,如程序性死亡受体1(PD-1)和细胞毒性T淋巴细胞相关抗原4(CTLA-4),是免疫反应的关键调节因子,充当平衡针对外来抗原的免疫和自身耐受性的守门人。这些检查点通过防止免疫介导的对心脏等关键器官的损伤,在维持心脏内环境稳态中发挥关键作用。在本研究中,我们探讨了PD-1和CTLA-4在心血管并发症,特别是动脉粥样硬化和心肌炎中的作用,这些并发症可导致心力衰竭。我们使用动物模型和临床数据进行了全面分析,以评估免疫检查点抑制对心脏功能的影响。我们的研究结果表明,PD-1和CTLA-4信号通路的破坏会加剧心肌炎症,加速动脉粥样硬化斑块形成,并促进心力衰竭的发展。此外,我们观察到在这些模型中免疫检查点抑制导致T淋巴细胞浸润增加、促炎细胞因子水平升高以及组织损伤加重。这些结果表明,PD-1和CTLA-4对维持心脏健康至关重要,对它们的抑制可导致严重的心血管毒性。我们的研究强调了对接受免疫检查点抑制剂治疗的患者进行心血管健康仔细监测的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf8a/12006013/032c9988b260/fimmu-16-1561968-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf8a/12006013/2aa2bad4d48e/fimmu-16-1561968-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf8a/12006013/f785a9d00638/fimmu-16-1561968-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf8a/12006013/c986ffdc1df9/fimmu-16-1561968-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf8a/12006013/b9d0ac48e494/fimmu-16-1561968-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf8a/12006013/032c9988b260/fimmu-16-1561968-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf8a/12006013/2aa2bad4d48e/fimmu-16-1561968-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf8a/12006013/f785a9d00638/fimmu-16-1561968-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf8a/12006013/c986ffdc1df9/fimmu-16-1561968-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf8a/12006013/b9d0ac48e494/fimmu-16-1561968-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf8a/12006013/032c9988b260/fimmu-16-1561968-g005.jpg

相似文献

[1]
The role of immune checkpoints PD-1 and CTLA-4 in cardiovascular complications leading to heart failure.

Front Immunol. 2025-4-4

[2]
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[3]
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[4]
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[6]
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[7]
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[8]
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[9]
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[10]
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引用本文的文献

[1]
The Loss of Gonadal Hormones Has a Different Impact on Aging Female and Male Mice Submitted to Heart Failure-Inducing Metabolic Hypertensive Stress.

Cells. 2025-6-9

本文引用的文献

[1]
Immune Checkpoints Are New Therapeutic Targets in Regulating Cardio-, and Cerebro-Vascular Diseases and CD4Foxp3 Regulatory T Cell Immunosuppression.

Int J Drug Discov Pharm. 2024-12

[2]
Immune responses in checkpoint myocarditis across heart, blood and tumour.

Nature. 2024-12

[3]
Cardiovascular adverse events and immune-related adverse events associated with PD-1/PD-L1 inhibitors for head and neck squamous cell carcinoma (HNSCC).

Sci Rep. 2024-10-29

[4]
Pembrolizumab-Associated Cardiotoxicity: A Retrospective Analysis of the FDA Adverse Events Reporting System.

Pharmaceuticals (Basel). 2024-10-15

[5]
Injury-induced myosin-specific tissue-resident memory T cells drive immune checkpoint inhibitor myocarditis.

Proc Natl Acad Sci U S A. 2024-10-15

[6]
Molecular fingerprints of cardiovascular toxicities of immune checkpoint inhibitors.

Basic Res Cardiol. 2025-2

[7]
Immune-checkpoint inhibitor-mediated myocarditis: CTLA4, PD1 and LAG3 in the heart.

Nat Rev Cancer. 2024-8

[8]
Anti-CTLA-4 m2a Antibody Exacerbates Cardiac Injury in Experimental Autoimmune Myocarditis Mice By Promoting Ccl5-Neutrophil Infiltration.

Adv Sci (Weinh). 2024-9

[9]
Inflammation in heart failure: pathophysiology and therapeutic strategies.

Inflamm Res. 2024-5

[10]
Immune checkpoint inhibitors associated cardiovascular immune-related adverse events.

Front Immunol. 2024-2-5

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