The Cardioprotective Role of Myeloid-derived Suppressor Cells in Heart Failure
Background—Myeloid-derived suppressor cells (MDSCs) are a heterogeneous population of cells that expand in cancer, inflammation, and infection and negatively regulate inflammation and the immune response. Heart failure (HF) is a complex clinical syndrome, wherein inflammation induction and incomplete resolution can potentially contribute to HF development and progression. However, the role of MDSCs in HF remains unclear.
Methods—The percentage of MDSCs in HF patients and in mice with pressure overload-induced HF using isoproterenol (ISO) infusion or transverse aortic constriction (TAC), was detected by flow cytometry. The effects of MDSCs on ISO- or TAC-induced HF were observed upon depleting MDSCs with 5-fluorouracil (50 mg/kg) or gemcitabine (120 mg/kg), transferring purified MDSCs, or enhancing endogenous MDSCs with rapamycin (2 mg/kg/day). Hypertrophic markers and inflammatory factors were detected by enzyme-linked immunosorbent assay, real-time polymerase chain reaction, or western blot. Cardiac functions were determined by echocardiography and hemodynamic analysis.
Results—The percentage of human leukocyte antigen-D-related (HLA-DR)-CD33+CD11b+ MDSCs in the blood of HF patients was significantly increased and positively correlated with the disease severity and increased plasma levels of cytokines, including interleukin (IL)-6, IL-10, and transforming growth factor-β. Furthermore, HF patient-derived MDSCs inhibited T-cell proliferation and interferon-γ secretion. Similar results were observed in TAC- and ISO-induced HF in mice. Importantly, pharmaceutical depletion of MDSCs significantly exacerbated ISO- and TAC-induced pathological cardiac remodeling and inflammation, whereas adoptive transfer of MDSCs prominently rescued ISO- and TAC-induced HF. Consistently, administration of rapamycin significantly increased endogenous MDSCs by suppressing their differentiation and improved ISO- and TAC-induced HF, but MDSC depletion mostly blocked beneficial rapamycin-mediated effects. Mechanistically, MDSC-secreted molecules suppressed ISO-induced hypertrophy and proinflammatory genes expression in cardiomyocytes in a co-culture system. Neutralization of IL-10 blunted both monocytic MDSC (M-MDSC)- and granulocytic MDSC (G-MDSC)-mediated anti-inflammatory and antihypertrophic effects, but treatment with a nitric oxide (NO) inhibitor only partially blocked the antihypertrophic effect of M-MDSCs.
Conclusions—Our findings revealed a cardioprotective role of MDSCs in HF by their antihypertrophic effects on cardiomyocytes and anti-inflammatory effects through IL-10 and NO. Pharmacological targeting of MDSCs by rapamycin constitutes a promising therapeutic strategy for HF.
- myeloid-derived suppressor cells
- heart failure
- cardiac hypertrophy
- nitric oxide
- Received August 1, 2017.
- Revision received December 19, 2017.
- Accepted January 16, 2018.
Circulation is published on behalf of the American Heart Association, Inc., by Wolters Kluwer. This is an open access article under the terms of the Creative Commons Attribution Non-Commercial License (http://creative commons.org/licenses/by-nc/3.0/), which permits use, distribution, and reproduction in any medium, provided that the original work is properly cited and is not used for commercial purposes.