Heart failure promotes multimorbidity through innate immune memory

Sci Immunol. 2024 May 24;9(95):eade3814. doi: 10.1126/sciimmunol.ade3814. Epub 2024 May 24.

Abstract

Patients with heart failure (HF) often experience repeated acute decompensation and develop comorbidities such as chronic kidney disease and frailty syndrome. Although this suggests pathological interaction among comorbidities, the mechanisms linking them are poorly understood. Here, we identified alterations in hematopoietic stem cells (HSCs) as a critical driver of recurrent HF and associated comorbidities. Bone marrow transplantation from HF-experienced mice resulted in spontaneous cardiac dysfunction and fibrosis in recipient mice, as well as increased vulnerability to kidney and skeletal muscle insults. HF enhanced the capacity of HSCs to generate proinflammatory macrophages. In HF mice, global chromatin accessibility analysis and single-cell RNA-seq showed that transforming growth factor-β (TGF-β) signaling was suppressed in HSCs, which corresponded with repressed sympathetic nervous activity in bone marrow. Transplantation of bone marrow from mice in which TGF-β signaling was inhibited similarly exacerbated cardiac dysfunction. Collectively, these results suggest that cardiac stress modulates the epigenome of HSCs, which in turn alters their capacity to generate cardiac macrophage subpopulations. This change in HSCs may be a common driver of repeated HF events and comorbidity by serving as a key carrier of "stress memory."

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Heart Failure* / immunology
  • Hematopoietic Stem Cells / immunology
  • Immunity, Innate*
  • Immunologic Memory*
  • Macrophages / immunology
  • Male
  • Mice
  • Mice, Inbred C57BL*
  • Multimorbidity
  • Signal Transduction / immunology
  • Trained Immunity
  • Transforming Growth Factor beta / metabolism

Substances

  • Transforming Growth Factor beta