Congenital Heart Disease: An Immunological Perspective

Abstract

Congenital heart disease (CHD) poses a significant global health and economic burden—despite advances in treating CHD reducing the mortality risk, globally CHD accounts for approximately 300,000 deaths yearly. Children with CHD experience both acute and chronic cardiac complications, and though treatment options have improved, some remain extremely invasive. A challenge in addressing these morbidity and mortality risks is that little is known regarding the cause of many CHDs and current evidence suggests a multifactorial etiology. Some studies implicate an immune contribution to CHD development; however, the role of the immune system is not well-understood. Defining the role of the immune and inflammatory responses in CHD therefore holds promise in elucidating mechanisms underlying these disorders and improving upon current diagnostic and treatment options. In this review, we address the current knowledge coinciding CHDs with immune and inflammatory associations, emphasizing conditions where this understanding would provide clinical benefit, and challenges in studying these mechanisms.

Accelerated Cardiac Aging in Patients With Congenital Heart Disease

“…Systemic chronic inflammation and immune activation are crucial determinant in the pathogenesis of various cardiovascular diseases and therefore regarded as potential therapeutic targets. Accumulating evidence indicates chronic inflammation and immune senescence have a pathogenic relevance in the progressive deterioration of heart function in patients with CHD ( 113 ).…”

“…Abnormalities in the inflammatory response and immaturity of the immune system predispose to infection by common pathogens, such as respiratory syncytial virus, and to increased risk of developing bronchopneumonia and sepsis. The readers are invited to consult an extensive review of the immune and inflammatory markers associated with CHD from Singampalli et al ( 113 ). Most common features include reduced granulocyte activity against bacterial infections, T and B lymphocyte levels, naïve T-cell production and T-Cell Receptor Excision Circles (TREC) levels IgA and IgG levels, and complement levels, as well as increased suppressor T-cell function.…”

Maternal serum CFHR4 protein as a potential non-invasive marker of ventricular septal defects in offspring: evidence from a comparative proteomics study

“…A rat model study has shown that maternal anti-cardiac-myosin autoantibodies could enter fetal circulation through placental passage and increase the risk of fetal structural heart defects [ 24 ]. Researchers have noticed the associations of immune and inflammatory associations for a long time, and emphasized the significance of studying CHD from an immunological perspective [ 25 ]. The underlying mechanisms for these associations remain unclear.…”

“…Genetic variations in CFHR4 gene have been linked to age-related macular degeneration, systemic lupus erythematosus, and atypical hemolytic uremic syndrome [ 33 ]. And maternal systemic lupus erythematosus is a known risk factor of congenital heart defects [ 25 ]. It is still unclear what the role of CFHR4 is within the complement system as well as in fetal cardiac development.…”

Left Pulmonary Artery Coarctation Associated with Pneumonia and Pulmonary Hypertension in a Cat

“…In the present case, pulmonary hypoperfusion of the left lung and pneumonia were likely responsible for this clinical presentation. Pneumonia is often reported in infants affected by congenital heart disease [25] but it is rarely described in cats with similar conditions [4,26]. Severe congenital heart diseases can have serious consequences on the cardiovascular and respiratory systems, impairing the normal mechanisms of pressure and volume control.…”