Immunological Regulation of Fibrosis During Heart Failure: It Takes Two to Tango

Immuno-fibrotic networks and their protein mediators, such as cytokines and chemokines, have increasingly been appreciated for their critical role in cardiac healing and fibrosis during cardiomyopathy. Immune activation, trafficking, and extravasation are tightly regulated to ensure a targeted and e...

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Main Authors: Vinay Kumar, Shyam S. Bansal
Format: Article
Language:English
Published: MDPI AG 2025-01-01
Series:Biomolecules
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Online Access:https://www.mdpi.com/2218-273X/15/1/58
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author Vinay Kumar
Shyam S. Bansal
author_facet Vinay Kumar
Shyam S. Bansal
author_sort Vinay Kumar
collection DOAJ
description Immuno-fibrotic networks and their protein mediators, such as cytokines and chemokines, have increasingly been appreciated for their critical role in cardiac healing and fibrosis during cardiomyopathy. Immune activation, trafficking, and extravasation are tightly regulated to ensure a targeted and effective response against non-self antigens/pathogens while preserving tolerance towards self-antigens and coordinate fibrotic responses for efficient scar formation, a distinction that is severely compromised during chronic diseases. It is clear that immune cells are not only the critical regulators of post-infarct healing and scarring but are also the key players in regulating fibroblast activation during left-ventricular (LV) remodeling. Incomplete resolution coupled with sustained low-grade inflammation during dilated cardiomyopathy precipitates a “frustrated” immune cell response resulting in unconstrained pro-fibrotic and pro-hypertrophic signaling to induce maladaptive structural and functional changes in the myocardium. The aims of this review are to (i) briefly summarize the role of key immune cells that regulate wound healing during MI and fibrosis during LV remodeling; (ii) underscore phenotypic diversities in immune cells and their subsets to underscore their role in regulating fibrotic responses, and, last but not the least, (iii) highlight gaps in our understanding that restrict the translation of immuno-modulatory therapies from the preclinical models to heart failure patients.
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spelling doaj-art-97ed5bfb3e9a4d7f8b40be0c68752a092025-01-24T13:25:01ZengMDPI AGBiomolecules2218-273X2025-01-011515810.3390/biom15010058Immunological Regulation of Fibrosis During Heart Failure: It Takes Two to TangoVinay Kumar0Shyam S. Bansal1Heart and Vascular Institute, Pennsylvania State University Hershey Medical Center, Hershey, PA 17033, USAHeart and Vascular Institute, Pennsylvania State University Hershey Medical Center, Hershey, PA 17033, USAImmuno-fibrotic networks and their protein mediators, such as cytokines and chemokines, have increasingly been appreciated for their critical role in cardiac healing and fibrosis during cardiomyopathy. Immune activation, trafficking, and extravasation are tightly regulated to ensure a targeted and effective response against non-self antigens/pathogens while preserving tolerance towards self-antigens and coordinate fibrotic responses for efficient scar formation, a distinction that is severely compromised during chronic diseases. It is clear that immune cells are not only the critical regulators of post-infarct healing and scarring but are also the key players in regulating fibroblast activation during left-ventricular (LV) remodeling. Incomplete resolution coupled with sustained low-grade inflammation during dilated cardiomyopathy precipitates a “frustrated” immune cell response resulting in unconstrained pro-fibrotic and pro-hypertrophic signaling to induce maladaptive structural and functional changes in the myocardium. The aims of this review are to (i) briefly summarize the role of key immune cells that regulate wound healing during MI and fibrosis during LV remodeling; (ii) underscore phenotypic diversities in immune cells and their subsets to underscore their role in regulating fibrotic responses, and, last but not the least, (iii) highlight gaps in our understanding that restrict the translation of immuno-modulatory therapies from the preclinical models to heart failure patients.https://www.mdpi.com/2218-273X/15/1/58inflammationmonocytes and macrophagesT cellsmyocardial infarctionischemic heart failure
spellingShingle Vinay Kumar
Shyam S. Bansal
Immunological Regulation of Fibrosis During Heart Failure: It Takes Two to Tango
Biomolecules
inflammation
monocytes and macrophages
T cells
myocardial infarction
ischemic heart failure
title Immunological Regulation of Fibrosis During Heart Failure: It Takes Two to Tango
title_full Immunological Regulation of Fibrosis During Heart Failure: It Takes Two to Tango
title_fullStr Immunological Regulation of Fibrosis During Heart Failure: It Takes Two to Tango
title_full_unstemmed Immunological Regulation of Fibrosis During Heart Failure: It Takes Two to Tango
title_short Immunological Regulation of Fibrosis During Heart Failure: It Takes Two to Tango
title_sort immunological regulation of fibrosis during heart failure it takes two to tango
topic inflammation
monocytes and macrophages
T cells
myocardial infarction
ischemic heart failure
url https://www.mdpi.com/2218-273X/15/1/58
work_keys_str_mv AT vinaykumar immunologicalregulationoffibrosisduringheartfailureittakestwototango
AT shyamsbansal immunologicalregulationoffibrosisduringheartfailureittakestwototango