Immunity-diseases of the circulatory System
Immunity-diseases of the circulatory System
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Immunity-associated diseases of the cardiovascular system: Pathomechanisms and clinical relevance The circulatory System functions assigned to the supply of the organs with oxygen and nutrients and removal of metabolic waste products are for Survival is essential. In the last decades has shown that a number of diseases of this system are determined not only by conventional risk factors such as hypertension, hyperlipidemia, or Diabetes mellitus, but also by immunological processes are affected. Immune-mediated cardiovascular diseases include a heterogeneous group of diseases in which dysregulation of the immune system leads to an inflammatory response against the body's own structures. Among the most important categories: Rheumatic heart disease, in particular Streptococcus pyogenes infection, occurring in rheumatic fever with the following cardiac involvement (Endo‑, Myo‑ or pericarditis). Here, the phenomenon of molecular Mimikrie plays a Central role: antibodies against bacterial antigens react gewebsstrukturen cross with a Heart. Vasculitis, i.e., inflammation of the blood vessel walls. Systemic vasculitis such as Granulomatosis with Polyangiitis (GPA, formerly Wegener's Granulomatosis) or Polyarteritis nodosa may affect the coronary arteries or other vessels of the circulatory system and lead to Ischemia, Infarction, or aneurysms. Autoimmune‑associated cardiomyopathies, such as dilated cardiomyopathy with proven autoantibodies against the cardiac muscle proteins (such as β‑Adrenoceptors, or Myosin). Atherosclerosis as a chronic inflammatory disease. Meanwhile, atherosclerosis is considered as a purely degenerative process, but rather as a complex process with a crucial involvement of the immune system. Macrophages, T‑lymphocytes and inflammatory cytokines (e.g., TNF‑α, IL‑6) play an important role in Plaque formation and instability. Pathophysiological Mechanisms The common basis of many immune-associated cardiovascular diseases, there is a Dysregulation of the immune response is: Activation of the Inflammasome leads to the release of proinflammatory cytokines and initiates chronic inflammation in the vascular endothelium or the heart muscle. The formation of auto-antibodies against the body's own antigens (e.g., against phospholipids in the case of Antiphospholipid syndrome) may cause thrombus formation and Vascular occlusion. T‑cell‑mediated tissue damage occurs in myocardial inflammation, if the author of attack of active T‑cells, heart muscle cells. Immune complex deposits in the vascular wall (e.g., systemic Lupus erythematosus) can activate the complement system and cause a vasculitis. Clinical implications and therapeutic approaches The diagnostics includes, besides the classical cardiovascular examination (ECG, echocardiography, coronary angiography) also immunological Tests: Determination of autoantibodies (ANA, ANCA, Anti‑Myosin antibody) Measurement of markers of Inflammation (CRP, ESR, IL‑6) Tissue biopsy in vasculitic conditions for histological confirmation The therapy depends on the disease and aims to attenuate the immunological Hyperactivity: Corticosteroids (prednisone) as a basic medication to suppress the inflammation. Immunosuppressants, such as methotrexate, azathioprine or Mycophenolate mofetil for the reduction of the autoimmune reaction. Biologics (e.g., Anti‑TNF‑α antibody, Rituximab) for treatment-resistant forms. Adjuvant cardiovascular medications (beta blockers, ACE inhibitors, anticoagulants) to support the heart function, and thrombosis prophylaxis. Summary Immunity-associated cardiovascular diseases represent a major challenge for clinical medicine. A deeper understanding of the immunopathological mechanisms allows the development of targeted therapies and may improve the prognosis of this group of patients significantly. The close cooperation between cardiologists and rheumatologists/immunologists is of Central importance.
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Properties and disorders of the cardiovascular system The circulatory System (cardiovascular System) is a complex network for the continuous Transport of oxygen, nutrients, hormones and waste products in the body. It consists of the heart as the Central Pumporgan, as well as an extensive System of blood vessels — arteries, veins, and capillaries. Properties of the cardiovascular system The main features of this system are as follows: Central Pump (The Heart). The heart is a muscular hollow muscular organ that is divided into two hemispheres — the right and left — is. Each half consists of a courtyard (Atrium) and a chamber (ventricle). The regular contraction and Relaxation of the heart muscles, allows the continuous flow of blood. The blood vascular system. Arteries carry oxygen-rich blood from the heart to the organs and tissues, while veins deoxygenated blood back to the heart. Capillaries serve as a transition zone for the exchange of substances between the blood and tissues. Regulatory mechanisms. The System has a complex auto-regulatory and neuro-humoral mechanisms that maintain blood pressure, heart rate and vascular tone under different physiological conditions stable. Adaptability. The circulatory System can adapt to changing loads (e.g., physical activity, Stress), by modulating the cardiac output and the blood flow in a targeted manner. Homeostasis attitude. It plays a Central role in the maintenance of body temperature, Fluid balance and pH of the blood. Erhäufte diseases of the cardiovascular system Diseases of this system causes are one of the leading death in the world. The most common include: Coronary heart disease (CHD). By atherosclerosis caused by narrowing of the coronary arteries, which can lead to Angina pectoris or myocardial infarction. Arterial Hypertension. Chronically elevated blood pressure (> 140/90 mmHg), which increases the risk for stroke, heart attack, and kidney damage. Congestive heart failure. Dysfunction of the heart, when it is no longer sufficient blood can pump to supply the body. Arrhythmias. Disorders of the heart rhythm, such as atrial fibrillation or ventricular fibrillation, which can lead to seizures, thrombus formation, and embolic stroke. Atherosclerosis. Calcification and hardening of the arterial wall with Plaque formation, which restricts the flow of blood and lead to ischemic events. Cardiomyopathies. Diseases of the heart muscles, to structural and functional changes. Malformations flaps. Malfunction of the heart valves (e.g., aortic stenosis, mitral regurgitation), which interfere with the blood circulation. Prevention and treatment A healthy lifestyle — regular exercise, balanced diet, not Smoking, and alcohol, as well as the continuous monitoring of risk factors (blood pressure, cholesterol, blood sugar) are diseases of the essential measures for the prevention of cardiovascular disease. In the case of existing disease medications (e.g., beta‑blockers, ACE inhibitors, statins), catheter intervention and surgery are available.