Novel Therapeutics and Upcoming Clinical Trials Targeting Inflammation in Cardiovascular Diseases

Contributions of Noncardiac Organ-Heart Immune Crosstalk and Somatic Mosaicism to Heart Failure: Current Knowledge and Perspectives

Heart failure is the final outcome of most cardiovascular diseases and shares risk factors with other cardiovascular pathologies. Among these, inflammation plays a central role in disease progression and myocardial remodeling. Over the past 2 decades, numerous studies have explored immune-related mechanisms in cardiovascular disease, highlighting the importance of immune cross-talk between the heart and extra-cardiac organs, including bone marrow, spleen, liver, gut, and adipose tissue. This review examines how immune interactions among these organs contribute to heart failure pathogenesis, with a focus on clonal hematopoiesis, an age-related alteration of hematopoietic stem cells that fosters pathological bone marrow-heart communication. Additionally, we explore recent advances in the understanding of clonal hematopoiesis and its role in heart failure, emphasizing its implications for prognosis and potential therapeutic interventions. By integrating insights from immunology, metabolism, and aging, we provide a comprehensive perspective on the immunologic determinants of heart failure, paving the way for precision medicine approaches aimed at mitigating cardiovascular risk.

Hypercholesterolemia, oxidative stress, and low-grade inflammation: a potentially dangerous scenario to blood-brain barrier

For more than a century, hypercholesterolemia has been linked to atherosclerotic cardiovascular disease. Notably, this metabolic condition has also been pointed out as a risk factor for neurodegenerative diseases, such as Alzheimer's disease (AD). Oxidative stress seems to be the connective factor between hypercholesterolemia and cardio and neurological disorders. By disturbing redox homeostasis, hypercholesterolemia impairs nitric oxide (NO) availability, an essential vasoprotective element, and jeopardizes endothelial function and selective permeability. The central nervous system (CNS) is partially protected from peripheral insults due to an arrangement between endothelial cells, astrocytes, microglia, and pericytes that form the blood-brain barrier (BBB). The endothelial dysfunction related to hypercholesterolemia increases the risk of developing cardiovascular diseases and also initiates BBB breakdown, which is a cause of brain damage characterized by neuroinflammation, oxidative stress, mitochondrial dysfunction, and, ultimately, neuronal and synaptic impairment. In this regard, we reviewed the mechanisms by which hypercholesterolemia-induced oxidative stress affects peripheral vessels, BBB, and leads to memory deficits. Finally, we suggest oxidative stress as the missing link between hypercholesterolemia and dementia.

Cancer-associated fibroblasts (CAFs) and plaque-associated fibroblasts (PAFs): Unraveling the cellular crossroads of atherosclerosis and cancer

Atherosclerosis is a complex process involving various cells and molecules within the atherosclerotic plaque. Recent evidence suggests that plaque-associated fibroblasts (PAFs), also known as atherosclerosis-associated fibroblasts (AAFs), might play a significant role in the development and progression of the disease. The microenvironment of the atherosclerotic plaque, resembling the tumor microenvironment (TME), includes various cellular populations like plaque-associated macrophages (PAMs), plaque-associated neutrophils (PANs), vascular smooth muscle cells (VSMCs), myeloid-derived suppressor cells (MDSCs), and PAFs. Similar to cancer-associated fibroblasts (CAFs) in tumors, PAFs exhibits a wide range of characteristics and functions. Their interactions with endothelial cells, smooth muscle cells, and other stromal cells, including adventitial fibroblast precursors, significantly influence atherosclerosis progression. Moreover, the ability of PAFs to express various markers such as alpha-SMA, Desmin, VEGF, and GFAP, highlights their diverse origins from different precursor cells, including vascular smooth muscle cells, endothelial cells, glial cells of the enteric nervous system, adventitial fibroblast precursors, as well as resident and circulating fibrocytes. This article explores the molecular interactions between PAFs, cells associated with atherosclerosis, and other stromal cells. It further examines the role of PAFs in the development and progression of atherosclerosis, and compares their features with those of CAFs. The research suggests that studying tumor-associated fibroblasts can help understand fibroblast subpopulations in atherosclerotic plaque. Identifying specific subpopulations could provide new insight into atherosclerosis complexity and lead to the development of innovative drugs for medical intervention.

Colchicine in Coronary Artery Disease: Where Do We Stand?

ABSTRACT

Colchicine is an anti-inflammatory drug for different inflammatory conditions and is approved for secondary prevention of cardiovascular events in patients with coronary artery disease, mainly based on the results of the LODOCO2 and COLCOT trials. The recently published CLEAR SYNERGY trial reported neutral results for colchicine in patients with acute myocardial infarction undergoing percutaneous coronary intervention, challenging the previous reported benefits of colchicine. While colchicine appeared rather safe across the different studies, the variation in efficacy may suggest that the one-size-fits-all for the treatment of acute and chronic forms of coronary artery disease may not be appropriate, and that low-dose colchicine may be beneficial as an add-on therapy in patients who are stable or recovering from acute event, and not so helpful in patients with acute myocardial infarction already receiving intensive pharmaco-invasive therapies.

The relationship between VAI, LAP, and depression and the mediation role of sleep duration-evidence from NHANES 2005-2020

BACKGROUND

The relationship between obesity and mental health has attracted attention. However, large sample studies on the relationship between visceral fat obesity and depression are lacking. This study aimed to explore the relationship between visceral fat obesity and depression by using visceral adiposity index (VAI) and lipid accumulation product (LAP). Additionally, it sought to explore the potential mediating role of sleep duration in these associations.

METHODS

The data used in the current cross-sectional investigation are from the National Health and Nutrition Examination Survey (NHANES) spanning from 2005 to 2020, including 19,659 participants. Depression was measured using the nine-item Patient Health Questionnaire. Weighted multivariable regression analysis was used to evaluate the correlation of VAI and LAP with depression. The potential non-linear relationship was determined using smooth curve fitting and threshold effect analysis. Additionally, mediation analysis was performed to investigate the potential mediating role of sleep duration. The stability of the relationship was assessed through sensitivity analysis.

RESULTS

VAI and LAP were closely related to depression. In the fully adjusted model, VAI and LAP in the highest quartile increased the association of depression by 52% (OR = 1.52, 95% CI 1.20-1.92, P < 0.001) and 51% (OR = 1.51, 95% CI 1.19-1.91, P < 0.001), respectively, compared with the lowest quartile. Specific saturation effects for VAI, LAP, and depression were identified by smoothed curve fitting, with inflection points of 3.81 and 98.55, respectively. Additionally, mediation analysis revealed that 5.1% and 2.8% of the associations between VAI and LAP with depression were mediated through sleep duration. The results of the sensitivity analysis showed interactions between hypertension and cardiovascular disease in the associations of VAI, and depression (P < 0.05).

CONCLUSION

VAI and LAP are associated with depression in US adults. The associations between VAI and LAP with depression are non-linear, which may be mediated through sleep duration. The study highlights the potential of VAI and LAP as valuable tools for the prevention and management of depression.

An Attomolar-Level Optical Device for Monitoring Receptor-Analyte Interactions Without Functionalization Steps: A Case Study of Cytokine Detection

A plastic optical fiber (POF)-based device for biosensing strategies has been developed to monitor several protein-protein interactions at ultra-low concentrations without functionalization processes, exploiting plasmonic phenomena. In this work, novel tests were applied to different kinds of analyte-receptor interactions, such as interleukins, where the bioreceptor's (protein antibody) molecular weight is roughly ten times that of the analyte (protein interleukin), while intracellular bioreceptors and small molecules at low molecular weight interactions have already been demonstrated via the same point-of-care test (POCT). The POCT was implemented by a white light source and a spectrometer connected via two POF-based chips connected in series: an innovative microcuvette chip and a D-shaped POF surface plasmon resonance (SPR) probe. In particular, the POF microcuvette chip was achieved by drilling three micro holes in the core of a modified POF. Instead of performing a functionalization step, the micro holes were filled with a specific receptor solution for the analyte (one microliter at the femtomolar level), which selectively captured the target (e.g., cytokine) when the samples were dropped over the filled micro holes (twenty microliters at the attomolar level). Three interleukins, IL-1β, IL-17A, and IL-18, were detected in the attomolar concentrations range by monitoring the resonance wavelength shift over time due to the cytokine/antibody (protein-protein) interaction. The POF-based device was proven to be effective for detecting several interleukins at the attomolar level in a few minutes and without functionalization processes.

Atherosclerosis and the Bidirectional Relationship Between Cancer and Cardiovascular Disease: From Bench to Bedside, Part 2 Management

The first part of this review highlighted the evolving landscape of atherosclerosis, noting emerging cardiometabolic risk factors, the growing impact of exposomes, and social determinants of health. The prominent role of atherosclerosis in the bidirectional relationship between cardiovascular disease and cancer was also discussed. In this second part, we examine the complex interplay between multimorbid cardio-oncologic patients, cardiometabolic risk factors, and the harmful environments that lend a "syndemic" nature to these chronic diseases. We summarize management strategies targeting disordered cardiometabolic factors to mitigate cardiovascular disease and explore molecular mechanisms enabling more tailored therapies. Importantly, we emphasize the early interception of atherosclerosis through multifactorial interventions that detect subclinical signs (via biomarkers and imaging) to treat modifiable risk factors and prevent clinical events. A concerted preventive effort-referred to by some as a "preventome"-is essential to reduce the burden of atherosclerosis-driven chronic diseases, shifting from mere chronic disease management to the proactive promotion of "chronic health".

Fibrinogen Structural Changes and Their Potential Role in Endometriosis-Related Thrombosis

Endometriosis (EM), a chronic inflammatory condition predominantly affecting women of reproductive age, has been linked to an elevated risk of thrombosis, though its underlying molecular mechanisms remain incompletely understood. In this case-control study, involving 71 EM patients and 71 matched controls, we explored the structural and functional changes in fibrinogen and their potential role in thrombosis. Key oxidative stress markers, such as reactive oxygen species (ROS) levels in blood lymphocytes, monocytes, and granulocytes, along with plasma lipid peroxidation markers and total antioxidant capacity, were measured. Fibrinogen structure was examined using circular dichroism spectroscopy and intrinsic fluorescence, while functional properties were evaluated by analyzing thrombin-mediated polymerization and plasmin-induced lysis. Compared to controls, EM patients exhibited elevated ROS production and systemic oxidative stress, leading to notable fibrinogen oxidation and structural alterations. These changes were associated with impaired fibrin polymerization and enhanced resistance to plasmin-induced lysis, which are indicative of a pro-thrombotic state. These findings suggest that oxidative stress-driven fibrinogen modifications may contribute to the heightened thrombotic risk in women with EM, highlighting a potential therapeutic target to mitigate cardiovascular complications.