We’ve known for a long time that our heart “fixes” itself. Now we know better how
Surviving a heart attack leaves sequelae in the tissue of this muscular organ. As it does with wounds, our own body has a system to cleanse the injury and lay the foundation for recovery. The key is in the macrophages, cells of the immune system responsible for cleaning, but whose task in recovery is more complex. A team of North American researchers has studied how these macrophages act, an essential step in order to improve the care of those who suffer from this type of event throughout their lives.
Macrophages and VEGFC.
The immune system, more specifically the lymphatic system, plays a central role in the recovery of a heart after a heart attack. After this, the macrophages, cells of our immune system whose usual function is to destroy bacteria and regulate the inflammatory response by producing cytokines, come to work. Only this time his goal is to “eat” the muscle tissue damaged by the heart attack. This process is called efferocytosis.
But the work of the macrophages does not end there, as the team has discovered, and that is that, after starting their cleaning work, the macrophages allow the appearance of a protein called vascular endothelial growth factor (VEGFC). This substance, explains Edward Thorp, one of the researchers responsible for the study, “triggers the formation of new lymphatic vessels and promotes healing.”
Not all macrophages are the same.
The study also draws a distinction between what the authors call “good” and “bad” macrophages. The former would be those that induce the VEGFC factor, while the latter would be macrophages that are not related to the appearance of this protein but that do unleash an inflammatory response in the heart that ultimately ends up being harmful. According to Guillermo Oliver, co-author of the study, it is important to prevent these “bad” macrophages from causing more damage.
The value of new knowledge.
A heart attack increases the likelihood of future heart problems, especially heart failure, in which the organ simply isn’t able to do its job effectively enough. Medication is the only alternative today, but a better understanding of the heart’s healing process can help doctors ease patients’ recovery.
From mice to humans.
The group that has worked on this discovery has worked with mouse cells to be able to develop their model of how these macrophages work, but they hope that their discoveries can help in cardiac rehabilitation processes, in order to “intervene early and reactivate the course of cardiac repair,” explains Oliver.
The key would be to find a way to promote the presence of “good macrophages” while reducing or completely eliminating the presence of “bad” ones after a heart attack. Thorp also mentions the possibility of directly administering VEGFC protein to patients to speed up this process.
Cardiac Rehabilitation
Rehabilitation is an important part of the process to come out of a heart attack, and it involves not only physiological but also psychological factors. According to the Spanish Heart Foundation, this has three phases, starting with hospital admission, a post-hospital phase of learning and adaptation, and a third in which the patient will be the one to implement what has been learned. This last phase extends today throughout the life of the patient. Improvements in this process can therefore have a great impact on the quality of life of patients. However, it should always be remembered that prevention comes first.
