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Researcher Highlight Q&A: Antonio Abbate, MD, PhD, Studies the Immune System’s Role in Heart Disease

Antonio Abbate, MD, PhD, is a cardiologist and physician-scientist who treats patients with heart disease at UVA Health. He's currently the Ruth C. Heede Professor of Cardiology at the University of Virginia's School of Medicine and previously was awarded the Thames-Kontos Distinguished Mentor Award from the School of Medicine at Virginia Commonwealth University.

As a researcher, Abbate has a particular focus on the role of the body's immune system heart in the development of heart disease and injuries to the heart. By understanding how inflammation impacts heart disease, he and his team aim to develop new targeted therapies for patients with acute myocardial infarction, heart failure, pericarditis, and myocarditis.

At Abbate's lab, he and his researchers are currently studying the role of interleukin-1 (IL-1) in heart disease by enrolling eligible participants in the Virginia Anakinra Response Trial 4 (VA-ART4), a randomized, double-blinded clinical trial exploring the effects of IL-1 blockade on cardiac reserve and cardiorespiratory fitness in patients with ST-segment elevation myocardial infarction (STEMI).

See Abbates' selected publications. Below, Abbate discusses his work and answers our Researcher Highlight questions:

What are you working on right now?

I study how inflammation affects the health of the heart and vessels. This involves laboratory studies and clinical trials aimed at identifying the mechanism of disease and treatment target.

Specifically, we identify and block cytokines, like interleukin-1 and interleukin-6, to determine if doing so can prevent or treat heart diseases like heart failure, myocarditis, and pericarditis. I often use the term "cardio-immunology" to define the work done to understand how inflammation affects the heart and how it can be treated, then Cardio-Rheumatology to define how the heart and vessels may be affected by inflammation that is in the entire body, systemic, such as in Lupus or rheumatoid arthritis. Finally, Cardio-Oncology addresses how cancer and cancer treatments can threaten the health of the heart and vessels and what can be done to prevent or mitigate these side effects. I am also intrigued by the connections between the brain and heart and how in some conditions this becomes abnormal and pathologic.

What are the most intriguing potential clinical applications of your work?  

We have known that inflammation is bad for the heart for a long time, but until recently we had no anti-inflammatory treatments for patients. We now have colchicine, an anti-inflammatory drug, to reduce the risk of recurrent heart attacks and strokes, and we have colchicine and rilonacept, a targeted interleukin-1 blocker in patients with pericarditis. We are studying these and other anti-inflammatory drugs to be given to patients suffering from a heart attack or heart failure.

By understanding the effects of local and systemic inflammation, we may be able to prevent and/or mitigate the negative effects of inflammation in patients with heart injury, rheumatologic disease, and/or cancer.

What made you choose UVA Health as the place to do your research?

UVA Health has a long tradition of successful translational research, meaning discovering new mechanisms and developing treatments for patients. With a combination of excellent clinical care and outstanding science laboratories, UVA Health is an exceptional place for physician-scientists.

At UVA Health, I am surrounded by like-minded researchers and I have access to state-of-the-art facilities.

What do you wish more people knew about your area of research? 

Treating inflammation in heart disease starts with prevention. A healthy diet, a good night's sleep, an exercise routine, and habits that reduce mental and physical stresses and avoid toxins or injury are key to preventing systemic inflammation. Anti-inflammatory drugs may be needed for cases when inflammation is exuberant and not resolving. We are lucky to now have better, more targeted treatments that improve efficacy and reduce side effects.

I would encourage people to be in charge of their health, know their risk factors and illnesses, embrace new treatments that derive from the efforts of careful and highly regulated research and, when treatment is in doubt, join a clinical trial so they can contribute to the treatments of the future.

How did you become interested in your area of research?

I started researching inflammation when I was in medical school in Rome, Italy. As I was learning about the different diseases of the heart and vessels, I realized that while we were accumulating knowledge, there were many more things that we did not understand, hence the need for research.

In particular, it seemed to me as a student, that patients with similar degrees of injury could have very different outcomes, with some recovering rapidly and others actually getting worse and not recovering. I learned that the modality with which your inflammatory system reacts to injury is variable and it may be a key determinant of the outcomes.

Along these lines, we have been studying ways to modulate the inflammatory response so as to limit further damage and facilitate healing. People are likely more familiar with these concepts since the COVID-19 pandemic. While we know that the COVID-19 virus causes the illness, not everyone has the same response to the virus, some have a cold that goes away in a few days, while in others the virus triggers a very strong, exuberant, inflammatory response that damages the lungs and requires powerful anti-inflammatory treatments.

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