A triple-node heart-brain neuroimmune loop underlying myocardial infarction

Cell. 2026 Feb 5;189(3):800-817.e20. doi: 10.1016/j.cell.2025.12.058. Epub 2026 Jan 27.

Abstract

Myocardial infarction (MI) triggers adverse cardiac events, immune responses, and nervous system activation, but the neural and neuroimmune mechanisms remain understudied. Using single-cell RNA sequencing (scRNA-seq) and tissue clearing, we identified transient receptor potential vanilloid-1 (TRPV1)-expressing vagal sensory neurons (VSNs) that increase ventricular innervation post MI. Ablating these VSNs mitigated MI pathology, reducing infarct size, abnormal electrocardiograms, cardiac dysfunction, sympathetic innervation, and pro-inflammatory cytokine interleukin 1β (IL-1β). Single-nuclei RNA-seq (snRNA-seq) and spatial transcriptomics revealed reduced border zone expansion in MI hearts following VSN ablation. Tracing the effects to the brain, we found that MI activated angiotensin II receptor type 1 (AT1aR)-expressing neurons in the paraventricular nucleus (PVN), whose inhibition mirrored benefits of TRPV1 VSN ablation. Additionally, the superior cervical ganglia (SCGs) exhibited intensified post-MI sympathetic innervation and IL-1β signaling. Blocking IL-1β in the SCG significantly reduced complications post MI. This study reveals a triple-node heart-brain loop underlying MI and potential therapeutic targets.

Keywords: cardioception; central circuits; heart-brain; hypothalamus; immune system; inflammation; myocardial infarction; peripheral circuits; sympathetic ganglia; vagus nerve.

MeSH terms

  • Animals
  • Brain* / immunology
  • Brain* / metabolism
  • Heart* / innervation
  • Heart* / physiopathology
  • Interleukin-1beta / metabolism
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Myocardial Infarction* / immunology
  • Myocardial Infarction* / metabolism
  • Myocardial Infarction* / pathology
  • Myocardial Infarction* / physiopathology
  • Myocardium / metabolism
  • Myocardium / pathology
  • Neuroimmunomodulation*
  • Paraventricular Hypothalamic Nucleus / metabolism
  • Receptor, Angiotensin, Type 1 / metabolism
  • Sensory Receptor Cells / metabolism
  • Signal Transduction
  • TRPV Cation Channels / genetics
  • TRPV Cation Channels / metabolism
  • Vagus Nerve / metabolism

Substances

  • TRPV Cation Channels
  • Interleukin-1beta
  • TRPV1 protein, mouse
  • Receptor, Angiotensin, Type 1