Ge Zhao, Wu Guoyu, Ma Jingguo, Ren Silin, Liu Tongzuo, Wu Xudong, Wang Xianliang
First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China.
Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
Front Immunol. 2025 Aug 29;16:1631083. doi: 10.3389/fimmu.2025.1631083. eCollection 2025.
Please confirm that the below Frontiers AI generated Alt-Text is an accurate visual description of your Figure(s). These Figure Alt-text proposals won't replace your figure captions and will not be visible on your article. If you wish to make any changes, kindly provide the exact revised Alt-Text you would like to use, ensuring that the word-count remains at approximately 100 words for best accessibility results. Further information on Alt-Text can be found here.Coronary microvascular disease (CMVD) represents a widespread but frequently underdiagnosed cardiovascular condition marked by endothelial dysfunction and inflammatory microvascular remodeling. Mounting evidence underscores the pivotal involvement of neuro-immune interactions in CMVD pathogenesis, encompassing complex bidirectional communication among the autonomic nervous system, immune cells, and vascular endothelium. This review first examines the evolving paradigm of neuro-immune cardiovascular circuits and elucidates critical signaling pathways-including NF-κB, MAPK, mTOR, STAT3, and cAMP-that govern these interactions. Subsequently, to provide a clinical context for these underlying mechanisms, we present an in-depth analysis of recent clinical trials. We evaluate the evidence from large-scale cardiovascular outcome trials of anti-inflammatory agents like colchicine, alongside mechanism-based trials of vasodilators, novel cell-based therapies, and other targeted agents specifically in the CMVD population. This clinical evidence highlights the therapeutic promise of immunomodulation while underscoring the limitations of empirical, non-stratified treatment approaches. Finally, we posit that future progress depends on precision medicine frameworks that integrate neuro-immune profiling with mechanism-based patient stratification. By synthesizing contemporary mechanistic understanding and robust clinical evidence, this review advances novel diagnostic and therapeutic perspectives through a neuro-immunological lens.
请确认以下由Frontiers AI生成的替代文本是否准确描述了您的图。这些图的替代文本建议不会取代您的图注，并且不会在您的文章中显示。如果您希望进行任何更改，请提供您想要使用的确切修订替代文本，确保字数保持在约100字以获得最佳可访问性结果。有关替代文本的更多信息可在此处找到。冠状动脉微血管疾病（CMVD）是一种广泛存在但经常被漏诊的心血管疾病，其特征是内皮功能障碍和炎症性微血管重塑。越来越多的证据强调神经免疫相互作用在CMVD发病机制中的关键作用，包括自主神经系统、免疫细胞和血管内皮之间复杂的双向通信。本综述首先探讨神经免疫心血管回路的演变模式，并阐明控制这些相互作用的关键信号通路，包括NF-κB、MAPK、mTOR、STAT3和cAMP。随后，为了为这些潜在机制提供临床背景，我们对近期临床试验进行了深入分析。我们评估了秋水仙碱等抗炎药物的大规模心血管结局试验的证据，以及基于机制的血管扩张剂试验、新型细胞疗法和专门针对CMVD人群的其他靶向药物试验。这一临床证据突出了免疫调节的治疗前景，同时强调了经验性、非分层治疗方法的局限性。最后，我们认为未来的进展取决于将神经免疫分析与基于机制的患者分层相结合的精准医学框架。通过综合当代的机制理解和有力的临床证据，本综述通过神经免疫学视角推进了新的诊断和治疗观点。
