Therapeutic Immunomodulation in Cardiovascular Disease: Anti-inflammatory Strategies and Landmark Trials

Abstract

Cardiovascular diseases (CVDs) are the leading cause of death across the world, resulting in a significant number of deaths each year. It has become clear that, alongside traditional risk factors, inflammation and immune dysregulation play a key role in the progression of these diseases. This review explores the new domain where immunology meets cardiology, particularly the bidirectional relationship between immunotherapy and CVDs. Treatments such as immune checkpoint inhibitors (ICIs) and chimeric antigen receptor (CAR) T-cell therapy were originally developed for cancer and autoimmune illnesses. They are currently under evaluation both for their potential applications in CVD and for the cardiotoxic effects associated with their administration. Mechanistic insights from translational research show that a complex interplay between cytokine signalling, autoimmunity, and vascular injury determines both the therapeutic benefit and toxicity. Not only this, but recent evidence has found that the use of anti-inflammatory drugs, such as interleukin-1 (IL-1) inhibitors and colchicine, notably reduces cardiovascular events, marking a shift towards immune-targeted therapies. However, the immune-mediated life-threatening conditions like myocarditis and vasculitis still exist, necessitating the need for better risk stratification and collaboration between cardiology and oncology. Future research might be directed towards using biomarker-guided monitoring, new classes of immunomodulators, and an overall precision-based approach to achieve both effectiveness and safety. Immunotherapy serves as a promising paradigm shift in cardiovascular medicine, linking two different fields in a way that redefines disease prevention and management.

Keywords: cardioimmunology; immune checkpoint inhibitors; immune-mediated myocarditis; inflammation and atherosclerosis; therapeutic immunomodulation.