Heart-brain axis in health and disease: role of innate and adaptive immunity

  • Cardiovasc Res. 2025 Apr 8;120(18):2325-2335. doi: 10.1093/cvr/cvae185.
Alba Simats  1 Hendrik B Sager  2  3 Arthur Liesz  4  5
Affiliations
  • 1. Department of Neuroscience and Experimental Therapeutics, Institute of Biomedical Research of Barcelona (IIBB), Spanish National Research Council (CSIC), c/Rosselló 161, 08036 Barcelona, Spain.
  • 2. DZHK (German Center for Cardiovascular Research), Partner site Munich Heart Alliance, Munich, Germany.
  • 3. Department of Cardiology, German Heart Centre Munich, Technical University of Munich, Munich, Germany.
  • 4. Institute for Stroke and Dementia Research (ISD), University Medical Center Munich, Feodor-Lynen-Straße 17, 81377 Munich, Germany.
  • 5. Munich Cluster for Systems Neurology (SyNergy), Feodor-Lynen-Str. 17, 81377 Munich, Germany.
Abstract

The importance of the brain-heart interaction has been increasingly recognized as a critical physiological axis that is altered in disease. In this review, we explore the intricate relationship between the central nervous system and cardiovascular health, focusing particularly on immunological mechanisms that influence the course of both neurological and cardiovascular diseases. While previous studies have established a key role of the autonomic nervous system (ANS) in linking brain and the heart, more recent studies have expanded our understanding of the multifaceted inter-organ interactions. As such, circulating mediators include immune cells of the adaptive and innate immune system and their secreted immunogenic factors have come into the focus as mediators along this bidirectional communication. Hence, in this review we briefly discuss the contribution of the ANS and then focus on innate and adaptive immune mechanisms along the heart-to-brain and brain-to-heart axes, illustrating how cardiovascular diseases affect cognitive functions and how brain pathologies lead to cardiac complications.

Keywords
Adaptive immunity; Cardiovascular diseases; Heart-brain interaction; Innate immunity.