上海交通大学学报（医学版）2025，Vol.45Issue(12)：1644-1653,10.DOI:10.3969/j.issn.1674-8115.2025.12.010
心肌梗死后造血失衡介导的心室重构:免疫细胞亚群的作用与干预新策略
Hematopoietic imbalance-mediated ventricular remodeling after myocardial infarction:roles of immune cell subsets and emerging therapeutic strategies
摘要
Abstract
Ventricular remodeling following myocardial infarction(MI)and its associated myocardial fibrosis represent a core pathological mechanism in the progression of heart failure.Accumulating evidence confirms that the spatiotemporal dynamics of immune cells play a crucial role in post-MI ventricular remodeling,spanning the entire process of cardiac inflammation,tissue repair,and fibrosis.MI not only triggers a local inflammatory response but also remotely regulates hematopoietic organs such as the bone marrow and spleen via pathways including inflammatory factor release and sympathetic nervous system activation.This drives hematopoietic stem/progenitor cells(HSPCs)to differentiate with a bias toward the myeloid lineage,resulting in a hematopoietic imbalance phenomenon described as"myeloid upsurge-lymphoid decline".This imbalance is characterized by excessive proliferation and release of proinflammatory myeloid cells,such as neutrophils and monocytes/macrophages,alongside a relative reduction in lymphoid cells like T cells and B cells.This systemic immune imbalance reshapes the immune cell composition in the heart and peripheral organs.It exacerbates sustained cardiac inflammation,oxidative stress,cell apoptosis,and excessive extracellular matrix deposition,ultimately leading to aggravated cardiac fibrosis,ventricular dilation,and systolic function deterioration.It is a key driver of adverse post-MI remodeling and the onset of heart failure.This article aims to systematically explore the spatiotemporal dynamics and functional characteristics of immune cell subsets driven by this post-MI hematopoietic imbalance.Furthermore,it proposes novel intervention strategies focused on precisely modulating hematopoietic stem cell differentiation pathway and key immune cell subsets.These strategies aim to improve the cardiac inflammatory microenvironment,delay the fibrotic process,and inhibit adverse ventricular remodeling,thereby offering potential therapeutic targets for preventing and treating post-MI heart failure.关键词
心肌梗死/造血失衡/心室重构/免疫谱系Key words
myocardial infarction/hematopoietic imbalance/ventricular remodeling/immune lineage分类
医药卫生引用本文复制引用
姜凯,徐越,杨兴博,王丹丹,项耀祖..心肌梗死后造血失衡介导的心室重构:免疫细胞亚群的作用与干预新策略[J].上海交通大学学报（医学版）,2025,45(12):1644-1653,10.基金项目
国家自然科学基金(82270350,82425060,82300381,82300326) （82270350,82425060,82300381,82300326）
中央高校基本科研业务费专项资金(22120220162) （22120220162）
上海市科技发展基金"扬帆计划"专项项目(23YF1434800). National Natural Science Foundation of China(82270350,82425060,82300381,82300326) （23YF1434800）
Fundamental Research Funds for the Central Universities(22120220162) （22120220162）
Shanghai Science and Technology Development Funds(Yangfan Special Project)(23YF1434800). （Yangfan Special Project）
