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Endre Szvetnik By Endre Szvetnik • July 2, 2018

Reining in immune cells to heal 'broken hearts'

The immune system causes extra heartbreak after a cardiac arrest. Finding a way to avoid it could speed up recoveryResearchers have linked the damaging inflammation observed after a heart attack to an incorrect immune response. Targeting the cells that are involved can help people recover faster.

In 10 seconds? It turns out cardiac arrest survivors' hearts suffer extra damage when the immune system tries to repair them using brute force. Fortunately, an existing drug can reduce the damage. (Read the science)

Is this for real – injured hearts get more damaged? Yes. It's as if the body used a scraper rather than a fine brush to remove broken tissue. The problem is that the immune cells (B-cells) sent in for the job trigger an inflammation that further scars the heart muscle, instead of letting it heal right away. (More on post heart attack inflammation)

Why not wipe out the culprits, then? That would be bad! The exaggerated inflammation is first of a three-stage healing process, followed by its reduction and cell repair. Research shows that completely wiping out the inflammatory B-cells leaves the heart unprotected. (Read about the healing process)

So, what can be done? Well, scientists have discovered that a drug used to reduce scars in a severe lung disease can protect the heart in an unexpected way. Heart tissue is slow to regenerate, so this drug, pirfenidone, cannot remove scars there. However, the heart does work better when it is administered – and crucially, when the inflammation-causing B-cells are present. (Read more)

Do we know why? We're just starting to find out with early stage studies involving lab mice. Researchers focusing on other immune cells were surprised to find B-cells as the drivers of the secondary heart damage. Their work shows that the drug alters these B-cells in a way that protects the heart. (More on the immune system and cardiac repair)

So can heart attack survivors use this drug? Not just yet. Scientists point out that it has some side effects, like nausea and vomiting. But having found the drug's target, they can now work on tweaking it for heart disease patients: by targeting the right immune cells in the repair process, they hope to scale down inflammation and encourage faster heart repair.

How long does it take to recover from a heart attack?

The good news is that people can survive heart attacks. The bad news is that they can still die from the heart failure that follows.

Therefore cardiac rehabilitation is very important.

This starts immediately in the hospital and recovery can last for months. Patients will most probably have to take drugs for the rest of their lives to avoid another attack.

People returning home will be advised to stick to light activities and only gradually increase them.

They will be told to introduce some lifestyle changes including changing their diet and quitting smoking.

(Psst, Endre distilled 9 research papers to save you 583.6 min)

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