title: The CXCL10/CXCR3 Axis and Cardiac Inflammation: Implications for Immunotherapy to Treat Infectious and Noninfectious Diseases of the Heart.
abstract: Accumulating evidence reveals involvement of T lymphocytes and adaptive immunity in the chronic inflammation associated with infectious and noninfectious diseases of the heart, including coronary artery disease, Kawasaki disease, myocarditis, dilated cardiomyopathies, Chagas, hypertensive left ventricular (LV) hypertrophy, and nonischemic heart failure. Chemokine CXCL10 is elevated in cardiovascular diseases, along with increased cardiac infiltration of proinflammatory Th1 and cytotoxic T cells. CXCL10 is a chemoattractant for these T cells and polarizing factor for the proinflammatory phenotype. Thus, targeting the CXCL10 receptor CXCR3 is a promising therapeutic approach to treating cardiac inflammation. Due to biased signaling CXCR3 also couples to anti-inflammatory signaling and immunosuppressive regulatory T cell formation when activated by CXCL11. Numbers and functionality of regulatory T cells are reduced in patients with cardiac inflammation, supporting the utility of biased agonists or biologicals to simultaneously block the pro-inflammatory and activate the anti-inflammatory actions of CXCR3. Other immunotherapy strategies to boost regulatory T cell actions include intravenous immunoglobulin (IVIG) therapy, adoptive transfer, immunoadsorption, and low-dose interleukin-2/interleukin-2 antibody complexes. Pharmacological approaches include sphingosine 1-phosphate receptor 1 agonists and vitamin D supplementation. A combined strategy of switching CXCR3 signaling from pro- to anti-inflammatory and improving Treg functionality is predicted to synergistically lessen adverse cardiac remodeling.
authors: Department of Pharmacology and Toxicology, School of Medicine, University of Mississippi Medical Center, Jackson, MS 39216-4500, USA.
authors: Raffaele
authors: 0000-0001-5590-6529
authors: R
authors: Altara
authors: Division of Cardiovascular Medicine, Department of Medicine, University of Cambridge, Cambridge CB20 SZ, UK; Institut National de la Santé et de la Recherche Médicale (Inserm), Unit 970, Paris Cardiovascular Research Center, 75015 Paris, France.
authors: Ziad
authors: Z
authors: Mallat
authors: Department of Pharmacology and Toxicology, School of Medicine, University of Mississippi Medical Center, Jackson, MS 39216-4500, USA.
authors: George W
authors: GW
authors: Booz
authors: Department of Pharmacology and Toxicology, American University of Beirut, Faculty of Medicine, Beirut 1107 2020, Lebanon.
authors: Fouad A
authors: FA
authors: Zouein
mesh_terms: D000818:Animals; D002318:Cardiovascular Diseases / Q000276:immunology / Q000503:physiopathology / Q000628:therapy*; D054357:Chemokine CXCL10 / Q000378:metabolism*; D054371:Chemokine CXCL11 / Q000276:immunology; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007167:Immunotherapy; D007249:Inflammation; D007376:Interleukin-2 / Q000627:therapeutic use; D054367:Receptors, CXCR3 / Q000378:metabolism* / Q000627:therapeutic use; D049349:Receptors, Lysosphingolipid; D015398:Signal Transduction; D050378:T-Lymphocytes, Regulatory / Q000276:immunology*; D014807:Vitamin D / Q000008:administration & dosage
chemical_list: C515202:CXCL11 protein, human; C515187:CXCR3 protein, human; D054357:Chemokine CXCL10; D054371:Chemokine CXCL11; D016756:Immunoglobulins, Intravenous; D007376:Interleukin-2; D054367:Receptors, CXCR3; D049349:Receptors, Lysosphingolipid; D014807:Vitamin D