Stress and Inflammation in Coronary Artery Disease: A Review Psychoneuroendocrineimmunology-Based

Abstract

Recent findings have deeply changed the current view of coronary heart disease, going beyond the simplistic model of atherosclerosis as a passive process involving cholesterol build-up in the subintimal space of the arteries until their final occlusion and/or thrombosis and instead focusing on the key roles of inflammation and the immune system in plaque formation and destabilization. Chronic inflammation is a typical hallmark of cardiac disease, worsening outcomes irrespective of serum cholesterol levels. Low-grade chronic inflammation correlates with higher incidence of several non-cardiac diseases, including depression, and chronic depression is now listed among the most important cardiovascular risk factors for poor prognosis among patients with myocardial infarction. In this review, we include recent evidence describing the immune and endocrine properties of the heart and their critical roles in acute ischaemic damage and in post-infarct myocardial remodeling. The importance of the central and autonomic regulation of cardiac functions, namely, the neuro-cardiac axis, is extensively explained, highlighting the roles of acute and chronic stress, circadian rhythms, emotions and the social environment in triggering acute cardiac events and worsening heart function and metabolism in chronic cardiovascular diseases. We have also included specific sections related to stress-induced myocardial ischaemia measurements and stress cardiomyopathy. The complex network of reciprocal interconnections between the heart and the main biological systems we have presented in this paper provides a new vision of cardiovascular science based on psychoneuroendocrineimmunology.

Immunosuppressive effect and global dysregulation of blood transcriptome in response to psychosocial stress in vervet monkeys (Chlorocebus sabaeus)

“…Short-term exposure to stress (on day 3) impacted the regulatory pathways of cell survival or cell death, and KEGG pathways associated with the activation of genes crucial for blood coagulation and platelet activation that play a pivotal role in cardiovascular disease 59 . Psychological stress has long been known to alter cardiovascular function and platelet activity 60,61 and our observation is consistent with the hypothesis that stress may potentiate coronary disease pathogenesis in part via the activation of blood platelets 62 . Short-term stress was also associated with the AMPK signaling pathway, which is involved in sensing cellular energy status, and MAPK pathway playing a key role in stress-induced depression 63,64 .…”

It is too soon to attribute ADE to COVID-19

“…As COVID-19 spread across the globe a common pattern of underlying morbid conditions such as diabetes and cardiovascular conditions is appearing. Such underlying conditions are known to present immune response dysfunction [3,4]. As reported by Channappanavar et al, immune dysregulation may contribute to lethal pneumonia induction by SARS-CoV [5].…”

Chia (Salvia hispanica L.) Seed Total Protein and Protein Fractions Digests Reduce Biomarkers of Inflammation and Atherosclerosis in Macrophages In Vitro

“…The plaque can also become unstable and thus rupture, leading to thrombosis, myocardial infarction, or stroke . Inflammation and atherosclerosis are closely related, since inflammation plays a role in all atherogenesis steps, like foam cell accumulation, fibrous plaque formation, acute plaque fissuring, rupture, and thrombosis …”