Lookup NU author(s): Dr Stephen Boag,
Dr Emanuele Andreano,
Professor Ioakim Spyridopoulos
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© 2017, Mary Ann Liebert, Inc. Significance: Myocardial ischemia/reperfusion (I/R) is an important complication of reperfusion therapy for myocardial infarction (MI). It is a complex process involving metabolic and immunological factors. To date, no effective treatment has been identified. Recent Advances: Previous research has focused on the role of innate immune cells in I/R injury. In recent years, increasing evidence has accumulated for an important role for adaptive immune cells, particularly T lymphocytes. Data from ST elevation MI patients have identified prognostic significance for lymphocyte counts, particularly postreperfusion lymphopenia. Dynamic changes in circulating CD4+ T cell subsets occurring early after reperfusion are associated with development of I/R injury in the form of microvascular obstruction. Transcoronary gradients in cell counts suggest sequestration of these cells into the reperfused myocardium. These findings support existing data from mouse models indicating a role for CD4+ T cells in I/R injury. It is clear, however, the effects of lymphocytes in the ischemic myocardium are time and subset specific, with some having protective effects, while others are pathogenic. Critical Issues: An understanding of the cellular events that lead to accumulation of lymphocytes in the myocardium, and their actions once there, is key to manipulating this process. Chemokines produced in response to ischemia and cellular injury have an important role, while lymphocyte-derived cytokines are critical in the balance between inflammation and healing. Future Directions: Further research into the involvement of lymphocytes in myocardial I/R injury may allow development of targeted therapies, opening a new avenue of considerable therapeutic potential.
Author(s): Boag SE, Andreano E, Spyridopoulos I
Publication type: Article
Publication status: Published
Journal: Antioxidants and Redox Signaling
Print publication date: 20/04/2017
Online publication date: 23/12/2016
Acceptance date: 21/12/2016
ISSN (print): 1523-0864
ISSN (electronic): 1557-7716
Publisher: Mary Ann Liebert Inc.
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