Following an individual’s survival of a heart attack, the heart experiences a limited timeframe in which it can recuperate if optimal conditions are present. However, more often than not, scar tissue develops in the regions that were deprived of oxygen during the cardiac event. This scar tissue diminishes heart performance, potentially escalating into heart failure, leading to a decreased quality of life and heightened chances of premature death.
A recent study spearheaded by Sumanth D. Prabhu, MD, the Tobias and Hortense Lewin Distinguished Professor of Cardiovascular Diseases and head of the Cardiovascular Division at WashU Medicine, along with Mohamed Ameen Ismahil, PhD, an assistant professor in the Cardiovascular Division, uncovered an unexpected function of the spleen — a small organ located near the ribs that filters blood and combats infections — in assisting the heart’s recovery post-heart attack.
The study, published in Circulation, revealed in mice that particular immune cells known as marginal metallophilic macrophages, which derive from the spleen, migrate from the spleen to the heart and contribute to a healing reaction following a heart attack.
Utilizing mouse models, single-cell RNA sequencing, and other advanced methodologies, the researchers determined that these specialized macrophages from the spleen aid in eliminating harmful immune cells, mitigating inflammation, and activating genes that assist in the repair of damaged cardiac tissue post-heart attack. To examine if a similar phenomenon occurs in humans, the researchers analyzed levels of marginal metallophilic macrophages in blood samples taken from individuals admitted to the hospital due to a heart attack. They compared these levels with cardiac patients who had coronary artery disease but had not recently experienced a heart attack. Prabhu and his team discovered that the levels of these specialized macrophages were elevated in patients who had just suffered a heart attack.
The researchers also illustrated that they could enhance the quantity of these specialized immune cells in mice using an experimental drug, and that this increase improved the healing and anti-inflammatory responses. Although this medical approach is not yet in clinical trials, it opens doors to potential future cardiac immunotherapy that focuses on the spleen to avert heart failure in patients who survive a heart attack, impacting hundreds of thousands of individuals in the U.S. annually.
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