BHF Professor Dorian Haskard’s team aims to understand the contribution of the immune system in disease of coronary arteries that supply the heart.
The build-up of dangerous fatty deposits in arteries, also known as atherosclerosis, lead to heart attack and stroke. Atherosclerotic build-up involves white blood cells that form part of our immune system’s natural defences.
The damaging process begins when pro-inflammatory genes get ‘switched on’ in the DNA of cells lining our arteries. Inflammation is a natural process in the body where immune cells rush to stamp out infection, or heal an injury. These signals are 'turned off' by anti-inflammatory genes. Professor Haskard and his team of researchers are working to understand this balance, and how we might tip it towards protection of arteries from disease.
Atherosclerosis tends to build up at branches and bends in arteries, where blood flow is slower. Professor Haskard's team is looking at how the speed of blood flow affects cells in the blood vessel lining.
Currently available medicines may influence the balance between switching on genes which promote inflammatory mechanisms, and switching on genes which stop this activity. The London team is investigating the effects of some drugs on these processes, particularly the involvement of white blood cells.
Who is at risk?
Maureen was affected by atherosclerosis and has had a heart attack and four procedures - called angioplasties - to insert stents into her arteries to keep them open, and stop her having further heart attacks. She says she’s living proof that you don’t have to fit the ‘profile’ of a heart attack victim to be affected by heart disease as she was healthy, a non-smoker and exercised regularly, but still has heart problems. If we could understand more about how the body builds up these fatty deposits, particularly in seemingly healthy people like Maureen, we could do more to help.
In atherosclerosis, white blood cells migrate from the blood stream into the vessel wall, through the blood vessel lining. Professor Haskard’s team is studying the underlying mechanisms involved in this trafficking. For example, they have found that white blood cells prefer to use certain areas of the blood vessel lining to migrate through into the vessel wall.
The team has also used a toxin from the West Indian Blistering Beetle to create small skin blisters which can be tested for white blood cell activity. The level of activity gives an insight into the strength of the inflammatory response in individuals. Use of this technique – in collaboration with now-retired BHF Professor of Cardiac Surgery, Ken Taylor – could help to identify those patients whose bodies react dangerously to heart operations.
Professor Haskard and the team at Hammersmith Hospital continue these studies, and many more, to clarify how our immune system can negatively affect our health through damaging inflammatory processes. Greater understanding could help us prevent the dangerous development of blood clots that cause heart attack and stroke, as well as exaggerated and harmful inflammatory responses during and after heart surgery.