Adaptive immune cells in calcific aortic valve disease

Am J Physiol Heart Circ Physiol. 2019 Jul 1;317(1):H141-H155. doi: 10.1152/ajpheart.00100.2019. Epub 2019 May 3.

Abstract

Calcific aortic valve disease (CAVD) is highly prevalent and has no pharmaceutical treatment. Surgical replacement of the aortic valve has proved effective in advanced disease but is costly, time limited, and in many cases not optimal for elderly patients. This has driven an increasing interest in noninvasive therapies for patients with CAVD. Adaptive immune cell signaling in the aortic valve has shown potential as a target for such a therapy. Up to 15% of cells in the healthy aortic valve are hematopoietic in origin, and these cells, which include macrophages, T lymphocytes, and B lymphocytes, are increased further in calcified specimens. Additionally, cytokine signaling has been shown to play a causative role in aortic valve calcification both in vitro and in vivo. This review summarizes the physiological presence of hematopoietic cells in the valve, innate and adaptive immune cell infiltration in disease states, and the cytokine signaling pathways that play a significant role in CAVD pathophysiology and may prove to be pharmaceutical targets for this disease in the near future.

Keywords: adaptive immunity; aortic valve; calcific aortic valve disease.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adaptive Immunity*
  • Animals
  • Aortic Valve / immunology*
  • Aortic Valve / metabolism
  • Aortic Valve / pathology*
  • Aortic Valve Stenosis / immunology*
  • Aortic Valve Stenosis / metabolism
  • Aortic Valve Stenosis / pathology
  • Calcinosis / immunology*
  • Calcinosis / metabolism
  • Calcinosis / pathology
  • Cytokines / immunology
  • Cytokines / metabolism
  • Humans
  • Immunity, Innate
  • Lymphocytes / immunology*
  • Lymphocytes / metabolism
  • Lymphocytes / pathology
  • Myeloid Cells / immunology*
  • Myeloid Cells / metabolism
  • Myeloid Cells / pathology
  • Signal Transduction

Substances

  • Cytokines

Supplementary concepts

  • Aortic Valve, Calcification of