Inflammation and repair in the ischaemic myocardium

Summary

Shortly after myocardial infarction, various circulating leukocyte subsets accumulate in the heart. Leukocyte recruitment is highly coordinated and relies on cell production in the bone marrow, mobilization to the blood, and chemokine-mediated infiltration to the destination tissue. Neutrophils, which are phagocytic and inflammatory, are among the first leukocytes to accumulate in large numbers. Within a day, neutrophils disappear and are replaced by a subset of monocytes that further contribute to inflammation and phagocytosis. After a few days, monocyte-derived reparative macrophages accrue, quell inflammation, and foster angiogenesis and tissue remodelling. Studies suggest a wellbalanced response comprising these three waves is essential to optimal infarct healing.

Zusammenfassung

Kurz nach einem Myokardinfarkt sammeln sich zirkulierende Leukozytenpopulationen im Herzen an. Die Rekrutierung der Leukozyten erfolgt sehr gezielt und beruht auf der Zellbildung im Knochenmark, Auswanderung in den Blutstrom und der durch Chemokine vermittelten Infiltration des Zielgewebes. Neutrophile gehören als phagozytierende und inflammatorische Zellen zu den ersten Leukozyten, die in großer Zahl akkumulieren. Innerhalb eines Tages werden die Neutrophilen durch Monozyten ersetzt, die ebenfalls zur Entzündung und Phagozytose beitragen. Nach einigen Tagen kommen von Monozyten stammende regenerative Makrophagen hinzu, die entzündungshemmend wirken und die Angiogenese und den Gewebeumbau fördern. Studien ergaben, dass eine ausgewogene Reaktion mit allen drei Stufen für eine optimale Infarktheilung maßgeblich ist.

Keywords

Inflammation - myocardium

Schlüsselwörter

Entzündung - Myokard

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