Immune Modulation in Heart Failure: the Promise of Novel Biologics

Immune Modulation in Heart Failure: the Promise of Novel Biologics Purpose of review Immune system activation plays a central role in heart failure progres- sion. Large-scale immune modulatory clinical trials targeting tumor necrosis factor-α and broad spectrum immune modulation have been negative. The objective of this review is to highlight past, present, and what is in the horizon for the immunomodulation in heart failure with a focus of biologics. Recent findings Strategies targeting interleukin-1 pathway are currently undergoing clinical evaluation and data from pilot studies are promising. The potential of cell therapy for immune modulation is increasingly recognized in clinical trials. Strategies targeting anti-cardiac antibodies such as immunoadsorption and intra- venous immunoglobulin have been used in clinical practice with positive out- comes but large pragmatic clinical trials are lacking. The use of an aptamer to block anti-cardiac antibodies is undergoing phase 1 clinical evaluation. Promising targets include inflammasomes, toll-like receptors, chemokines, natural killer cells, and macrophages. Summary Large-scale immune modulatory clinical trials have been negative. Nev- ertheless, the experience gained from them along with increasing understanding of molecular mechanisms of immune pathophysiology in heart failure is leading to rapid recognition of new therapeutic targets and approaches. 26 Page 2 of 13 Curr Treat Options Cardio Med (2018) 20: 26 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Current Treatment Options in Cardiovascular Medicine Springer Journals

Immune Modulation in Heart Failure: the Promise of Novel Biologics

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Publisher
Springer Journals
Copyright
Copyright © 2018 by Springer Science+Business Media, LLC, part of Springer Nature
Subject
Medicine & Public Health; Cardiology
ISSN
1092-8464
eISSN
1534-3189
D.O.I.
10.1007/s11936-018-0617-z
Publisher site
See Article on Publisher Site

Abstract

Purpose of review Immune system activation plays a central role in heart failure progres- sion. Large-scale immune modulatory clinical trials targeting tumor necrosis factor-α and broad spectrum immune modulation have been negative. The objective of this review is to highlight past, present, and what is in the horizon for the immunomodulation in heart failure with a focus of biologics. Recent findings Strategies targeting interleukin-1 pathway are currently undergoing clinical evaluation and data from pilot studies are promising. The potential of cell therapy for immune modulation is increasingly recognized in clinical trials. Strategies targeting anti-cardiac antibodies such as immunoadsorption and intra- venous immunoglobulin have been used in clinical practice with positive out- comes but large pragmatic clinical trials are lacking. The use of an aptamer to block anti-cardiac antibodies is undergoing phase 1 clinical evaluation. Promising targets include inflammasomes, toll-like receptors, chemokines, natural killer cells, and macrophages. Summary Large-scale immune modulatory clinical trials have been negative. Nev- ertheless, the experience gained from them along with increasing understanding of molecular mechanisms of immune pathophysiology in heart failure is leading to rapid recognition of new therapeutic targets and approaches. 26 Page 2 of 13 Curr Treat Options Cardio Med (2018) 20: 26

Journal

Current Treatment Options in Cardiovascular MedicineSpringer Journals

Published: Mar 15, 2018

References

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