Skip to main content
Top
Published in: BMC Immunology 1/2013

Open Access 01-12-2013 | Research article

The IL-6 response to Chlamydia from primary reproductive epithelial cells is highly variable and may be involved in differential susceptibility to the immunopathological consequences of chlamydial infection

Authors: Kelly Cunningham, Scott H Stansfield, Pooja Patel, Shruti Menon, Vivian Kienzle, John A Allan, Wilhelmina M Huston

Published in: BMC Immunology | Issue 1/2013

Login to get access

Abstract

Background

Chlamydia trachomatis infection results in reproductive damage in some women. The process and factors involved in this immunopathology are not well understood. This study aimed to investigate the role of primary human cellular responses to chlamydial stress response proteases and chlamydial infection to further identify the immune processes involved in serious disease sequelae.

Results

Laboratory cell cultures and primary human reproductive epithelial cultures produced IL-6 in response to chlamydial stress response proteases (CtHtrA and CtTsp), UV inactivated Chlamydia, and live Chlamydia. The magnitude of the IL-6 response varied considerably (up to 1000 pg ml-1) across different primary human reproductive cultures. Thus different levels of IL-6 production by reproductive epithelia may be a determinant in disease outcome. Interestingly, co-culture models with either THP-1 cells or autologous primary human PBMC generally resulted in increased levels of IL-6, except in the case of live Chlamydia where the level of IL-6 was decreased compared to the epithelial cell culture only, suggesting this pathway may be able to be modulated by live Chlamydia. PBMC responses to the stress response proteases (CtTsp and CtHtrA) did not significantly vary for the different participant cohorts. Therefore, these proteases may possess conserved innate PAMPs. MAP kinases appeared to be involved in this IL-6 induction from human cells. Finally, we also demonstrated that IL-6 was induced by these proteins and Chlamydia from mouse primary reproductive cell cultures (BALB/C mice) and mouse laboratory cell models.

Conclusions

We have demonstrated that IL-6 may be a key factor for the chlamydial disease outcome in humans, given that primary human reproductive epithelial cell culture showed considerable variation in IL-6 response to Chlamydia or chlamydial proteins, and that the presence of live Chlamydia (but not UV killed) during co-culture resulted in a reduced IL-6 response suggesting this response may be moderated by the presence of the organism.
Appendix
Available only for authorised users
Literature
2.
go back to reference Broeze KA, Opmeer BC, Coppus SF, Van Geloven N, Alves MF, Anestad G, Bhattacharya S, Allan J, Guerra-Infante MF, Den Hartog JE: Chlamydia antibody testing and diagnosing tubal pathology in subfertile women: an individual patient data meta-analysis. Hum Reprod Update. 2011, 17: 301-310. 10.1093/humupd/dmq060.CrossRefPubMed Broeze KA, Opmeer BC, Coppus SF, Van Geloven N, Alves MF, Anestad G, Bhattacharya S, Allan J, Guerra-Infante MF, Den Hartog JE: Chlamydia antibody testing and diagnosing tubal pathology in subfertile women: an individual patient data meta-analysis. Hum Reprod Update. 2011, 17: 301-310. 10.1093/humupd/dmq060.CrossRefPubMed
3.
go back to reference Lichtenwalner AB, Patton DL, Van Voorhis WC, Sweeney YT, Kuo CC: Heat shock protein 60 is the major antigen which stimulates delayed-type hypersensitivity reaction in the macaque model of Chlamydia trachomatis salpingitis. Infect Immun. 2004, 72: 1159-1161. 10.1128/IAI.72.2.1159-1161.2004.PubMedCentralCrossRefPubMed Lichtenwalner AB, Patton DL, Van Voorhis WC, Sweeney YT, Kuo CC: Heat shock protein 60 is the major antigen which stimulates delayed-type hypersensitivity reaction in the macaque model of Chlamydia trachomatis salpingitis. Infect Immun. 2004, 72: 1159-1161. 10.1128/IAI.72.2.1159-1161.2004.PubMedCentralCrossRefPubMed
4.
go back to reference Patton DL, Sweeney YT, Kuo CC: Demonstration of delayed hypersensitivity in Chlamydia trachomatis salpingitis in monkeys: a pathogenic mechanism of tubal damage. J Infect Dis. 1994, 169: 680-683. 10.1093/infdis/169.3.680.CrossRefPubMed Patton DL, Sweeney YT, Kuo CC: Demonstration of delayed hypersensitivity in Chlamydia trachomatis salpingitis in monkeys: a pathogenic mechanism of tubal damage. J Infect Dis. 1994, 169: 680-683. 10.1093/infdis/169.3.680.CrossRefPubMed
5.
go back to reference Tiitinen A, Surcel HM, Halttunen M, Birkelund S, Bloigu A, Christiansen G, Koskela P, Morrison SG, Morrison RP, Paavonen J: Chlamydia trachomatis and chlamydial heat shock protein 60-specific antibody and cell-mediated responses predict tubal factor infertility. Hum Reprod. 2006, 21: 1533-1538. 10.1093/humrep/del014.CrossRefPubMed Tiitinen A, Surcel HM, Halttunen M, Birkelund S, Bloigu A, Christiansen G, Koskela P, Morrison SG, Morrison RP, Paavonen J: Chlamydia trachomatis and chlamydial heat shock protein 60-specific antibody and cell-mediated responses predict tubal factor infertility. Hum Reprod. 2006, 21: 1533-1538. 10.1093/humrep/del014.CrossRefPubMed
6.
go back to reference Witkin SS, Askienazy-Elbhar M, Henry-Suchet J, Belaisch-Allart J, Tort-Grumbach J, Sarjdine K: Circulating antibodies to a conserved epitope of the Chlamydia trachomatis 60 kDa heat shock protein (hsp60) in infertile couples and its relationship to antibodies to C. trachomatis surface antigens and the Escherichia coli and human HSP60. Hum Reprod. 1998, 13: 1175-1179. 10.1093/humrep/13.5.1175.CrossRefPubMed Witkin SS, Askienazy-Elbhar M, Henry-Suchet J, Belaisch-Allart J, Tort-Grumbach J, Sarjdine K: Circulating antibodies to a conserved epitope of the Chlamydia trachomatis 60 kDa heat shock protein (hsp60) in infertile couples and its relationship to antibodies to C. trachomatis surface antigens and the Escherichia coli and human HSP60. Hum Reprod. 1998, 13: 1175-1179. 10.1093/humrep/13.5.1175.CrossRefPubMed
7.
go back to reference Baud D, Regan L, Greub G: Comparison of five commercial serological tests for the detection of anti-Chlamydia trachomatis antibodies. Eur J Clin Microbiol Infect Dis. 2010, 29: 669-675. 10.1007/s10096-010-0912-4.CrossRefPubMed Baud D, Regan L, Greub G: Comparison of five commercial serological tests for the detection of anti-Chlamydia trachomatis antibodies. Eur J Clin Microbiol Infect Dis. 2010, 29: 669-675. 10.1007/s10096-010-0912-4.CrossRefPubMed
8.
go back to reference Hjelholt A, Christiansen G, Johannesson TG, Ingerslev HJ, Birkelund S: Tubal factor infertility is associated with antibodies against Chlamydia trachomatis heat shock protein 60 but not human HSP60. Hum Reprod. 2011, 26: 2069-2076. 10.1093/humrep/der167.CrossRefPubMed Hjelholt A, Christiansen G, Johannesson TG, Ingerslev HJ, Birkelund S: Tubal factor infertility is associated with antibodies against Chlamydia trachomatis heat shock protein 60 but not human HSP60. Hum Reprod. 2011, 26: 2069-2076. 10.1093/humrep/der167.CrossRefPubMed
9.
go back to reference Stephens RS: The cellular paradigm of chlamydial pathogenesis. Trends Microbiol. 2003, 11: 44-51. 10.1016/S0966-842X(02)00011-2.CrossRefPubMed Stephens RS: The cellular paradigm of chlamydial pathogenesis. Trends Microbiol. 2003, 11: 44-51. 10.1016/S0966-842X(02)00011-2.CrossRefPubMed
10.
go back to reference Hvid M, Baczynska A, Deleuran B, Fedder J, Knudsen HJ, Chrisiansen G, Birkelund S: Interleukin-1 is the initiator of fallopian tube destruction during Chlamydia trachomatis infection. Cell Microbiol. 2007, 9: 2795-2803. 10.1111/j.1462-5822.2007.00996.x.CrossRefPubMed Hvid M, Baczynska A, Deleuran B, Fedder J, Knudsen HJ, Chrisiansen G, Birkelund S: Interleukin-1 is the initiator of fallopian tube destruction during Chlamydia trachomatis infection. Cell Microbiol. 2007, 9: 2795-2803. 10.1111/j.1462-5822.2007.00996.x.CrossRefPubMed
11.
go back to reference Huston WM, Armitage CW, Lawrence A, Gloeckl S, Bell SJ, Debattista J, Allan JA, Timms P: HtrA, RseP, and Tsp proteins do not elicit a pathology-related serum IgG response during sexually transmitted infection with Chlamydia trachomatis. J Reprod Immunol. 2010, 85: 168-171. 10.1016/j.jri.2010.02.007.CrossRefPubMed Huston WM, Armitage CW, Lawrence A, Gloeckl S, Bell SJ, Debattista J, Allan JA, Timms P: HtrA, RseP, and Tsp proteins do not elicit a pathology-related serum IgG response during sexually transmitted infection with Chlamydia trachomatis. J Reprod Immunol. 2010, 85: 168-171. 10.1016/j.jri.2010.02.007.CrossRefPubMed
12.
go back to reference Huston WM, Theodoropoulos C, Mathews SA, Timms P: Chlamydia trachomatis responds to heat shock, penicillin induced persistence, and IFN-gamma persistence by altering levels of the extracytoplasmic stress response protease HtrA. BMC Microbiol. 2008, 8: 190-10.1186/1471-2180-8-190.PubMedCentralCrossRefPubMed Huston WM, Theodoropoulos C, Mathews SA, Timms P: Chlamydia trachomatis responds to heat shock, penicillin induced persistence, and IFN-gamma persistence by altering levels of the extracytoplasmic stress response protease HtrA. BMC Microbiol. 2008, 8: 190-10.1186/1471-2180-8-190.PubMedCentralCrossRefPubMed
13.
go back to reference Lad SP, Li J, Correia JS, Pan Q, Gadwal S, Ulevitch RJ, Li E: Cleavage of p65/Re1A of the NF-kappa B pathway by Chlamydia. Proc Natl Acad Sci USA. 2007, 104: 2933-2938. 10.1073/pnas.0608393104.PubMedCentralCrossRefPubMed Lad SP, Li J, Correia JS, Pan Q, Gadwal S, Ulevitch RJ, Li E: Cleavage of p65/Re1A of the NF-kappa B pathway by Chlamydia. Proc Natl Acad Sci USA. 2007, 104: 2933-2938. 10.1073/pnas.0608393104.PubMedCentralCrossRefPubMed
14.
go back to reference Wu X, Lei L, Gong S, Chen D, Flores R, Zhong G: The chlamydial periplasmic stress response serine protease cHtrA is secreted into host cell cytosol. BMC Microbiol. 2011, 11: 87-10.1186/1471-2180-11-87.PubMedCentralCrossRefPubMed Wu X, Lei L, Gong S, Chen D, Flores R, Zhong G: The chlamydial periplasmic stress response serine protease cHtrA is secreted into host cell cytosol. BMC Microbiol. 2011, 11: 87-10.1186/1471-2180-11-87.PubMedCentralCrossRefPubMed
15.
go back to reference Castelbaum AJ, Ying L, Somkuti SG, Sun J, Ilesanmi AO, Lessey BA: Characterization of integrin expression in a well differentiated endometrial adenocarcinoma cell line (Ishikawa). J Clin Endocrinol Metab. 1997, 82: 136-142. 10.1210/jc.82.1.136.PubMed Castelbaum AJ, Ying L, Somkuti SG, Sun J, Ilesanmi AO, Lessey BA: Characterization of integrin expression in a well differentiated endometrial adenocarcinoma cell line (Ishikawa). J Clin Endocrinol Metab. 1997, 82: 136-142. 10.1210/jc.82.1.136.PubMed
16.
go back to reference Mo B, Vendrov AE, Palomino WA, DuPont BR, Apparao KB, Lessey BA: ECC-1 cells: a well-differentiated steroid-responsive endometrial cell line with characteristics of luminal epithelium. Biol Reprod. 2006, 75: 387-394. 10.1095/biolreprod.106.051870.CrossRefPubMed Mo B, Vendrov AE, Palomino WA, DuPont BR, Apparao KB, Lessey BA: ECC-1 cells: a well-differentiated steroid-responsive endometrial cell line with characteristics of luminal epithelium. Biol Reprod. 2006, 75: 387-394. 10.1095/biolreprod.106.051870.CrossRefPubMed
17.
go back to reference Bodetti TJ, Timms P: Detection of Chlamydia pneumoniae DNA and antigen in the circulating mononuclear cell fractions of humans and koalas. Infect Immun. 2000, 68: 2744-2747. 10.1128/IAI.68.5.2744-2747.2000.PubMedCentralCrossRefPubMed Bodetti TJ, Timms P: Detection of Chlamydia pneumoniae DNA and antigen in the circulating mononuclear cell fractions of humans and koalas. Infect Immun. 2000, 68: 2744-2747. 10.1128/IAI.68.5.2744-2747.2000.PubMedCentralCrossRefPubMed
18.
go back to reference Huston WM, Gloeckl S, de Boer L, Beagley KW, Timms P: Apoptosis is induced in Chlamydia trachomatis-infected HEp-2 cells by the addition of a combination innate immune activation compounds and the inhibitor wedelolactone. Am J Reprod Immunol. 2011, 65: 460-465. 10.1111/j.1600-0897.2010.00936.x.CrossRefPubMed Huston WM, Gloeckl S, de Boer L, Beagley KW, Timms P: Apoptosis is induced in Chlamydia trachomatis-infected HEp-2 cells by the addition of a combination innate immune activation compounds and the inhibitor wedelolactone. Am J Reprod Immunol. 2011, 65: 460-465. 10.1111/j.1600-0897.2010.00936.x.CrossRefPubMed
19.
go back to reference Dessus-Babus S, Darville T, Cuozzo FP, Ferguson K, Wyrick PB: Differences in the innate immune responses (in vitro) to HeLa cells infected with nondisseminating serovar E and disseminating serovar L2 of Chlamydia trachomatis. Infect Immun. 2002, 70: 3234-3248. 10.1128/IAI.70.6.3234-3248.2002.PubMedCentralCrossRefPubMed Dessus-Babus S, Darville T, Cuozzo FP, Ferguson K, Wyrick PB: Differences in the innate immune responses (in vitro) to HeLa cells infected with nondisseminating serovar E and disseminating serovar L2 of Chlamydia trachomatis. Infect Immun. 2002, 70: 3234-3248. 10.1128/IAI.70.6.3234-3248.2002.PubMedCentralCrossRefPubMed
20.
go back to reference Mpiga P, Mansour S, Morisset R, Beaulieu R, Ravaoarinoro M: Sustained interleukin-6 and interleukin-8 expression following infection with Chlamydia trachomatis serovar L2 in a HeLa/THP-1 cell co-culture model. Scand J Immunol. 2006, 63: 199-207. 10.1111/j.1365-3083.2006.01734.x.CrossRefPubMed Mpiga P, Mansour S, Morisset R, Beaulieu R, Ravaoarinoro M: Sustained interleukin-6 and interleukin-8 expression following infection with Chlamydia trachomatis serovar L2 in a HeLa/THP-1 cell co-culture model. Scand J Immunol. 2006, 63: 199-207. 10.1111/j.1365-3083.2006.01734.x.CrossRefPubMed
21.
go back to reference Rasmussen SJ, Eckmann L, Quayle AJ, Shen L, Zhang Y-X, Anderson DJ, Fierer J, Stephens RS, Kagnoff MF: Secretion of proinflammatory cytokines by epithelial cells in response to Chlamydia infection suggest a central role for eptihelial cells in chlamydial pathogenesis. J Clin Invest. 1997, 99: 77-87. 10.1172/JCI119136.PubMedCentralCrossRefPubMed Rasmussen SJ, Eckmann L, Quayle AJ, Shen L, Zhang Y-X, Anderson DJ, Fierer J, Stephens RS, Kagnoff MF: Secretion of proinflammatory cytokines by epithelial cells in response to Chlamydia infection suggest a central role for eptihelial cells in chlamydial pathogenesis. J Clin Invest. 1997, 99: 77-87. 10.1172/JCI119136.PubMedCentralCrossRefPubMed
22.
go back to reference Debattista J, Timms P, Allan J: Reduced levels of gamma-interferon secretion in response to chlamydial 60 kDa heat shock protein amongst women with pelvic inflammatory disease and a history of repeated Chlamydia trachomatis infections. Immunol Lett. 2002, 81: 205-210. 10.1016/S0165-2478(02)00036-6.CrossRefPubMed Debattista J, Timms P, Allan J: Reduced levels of gamma-interferon secretion in response to chlamydial 60 kDa heat shock protein amongst women with pelvic inflammatory disease and a history of repeated Chlamydia trachomatis infections. Immunol Lett. 2002, 81: 205-210. 10.1016/S0165-2478(02)00036-6.CrossRefPubMed
23.
go back to reference Srivastava P, Rajneesh J, Bas S, Salhan S, Mittal A: In infertile women, cells from Chlamydia trachomatis infected site release higher levels of interferon-gamma, interluekin-10 and tumor necrosis factor-alpha upon heat shock protein stimulation than fertile women. Reprod Biol Endo. 2008, 6: 20-25. 10.1186/1477-7827-6-20.CrossRef Srivastava P, Rajneesh J, Bas S, Salhan S, Mittal A: In infertile women, cells from Chlamydia trachomatis infected site release higher levels of interferon-gamma, interluekin-10 and tumor necrosis factor-alpha upon heat shock protein stimulation than fertile women. Reprod Biol Endo. 2008, 6: 20-25. 10.1186/1477-7827-6-20.CrossRef
24.
go back to reference Stansfield SH, Patel P, Debattista J, Armitage CW, Cunningham K, Timms P, Allan J, Mittal A, Huston WM: Proof of concept: a bioinformatic and serological screening method for identifying new peptide antigens for chlamydia trachomatis related sequelae in women. Res Immunol. 2013, in press Stansfield SH, Patel P, Debattista J, Armitage CW, Cunningham K, Timms P, Allan J, Mittal A, Huston WM: Proof of concept: a bioinformatic and serological screening method for identifying new peptide antigens for chlamydia trachomatis related sequelae in women. Res Immunol. 2013, in press
25.
go back to reference Kinnunen AH, Surcel HM, Halttunen M, Tiitinen A, Morrison RP, Morrison SG, Koskela P, Lehtinen M, Paavonen J: Chlamydia trachomatis heat shock protein -60 induced infterferon-gamma and interleukin-10 production in infertile women. Clin Exp Immunol. 2003, 131: 299-303. 10.1046/j.1365-2249.2003.02048.x.PubMedCentralCrossRefPubMed Kinnunen AH, Surcel HM, Halttunen M, Tiitinen A, Morrison RP, Morrison SG, Koskela P, Lehtinen M, Paavonen J: Chlamydia trachomatis heat shock protein -60 induced infterferon-gamma and interleukin-10 production in infertile women. Clin Exp Immunol. 2003, 131: 299-303. 10.1046/j.1365-2249.2003.02048.x.PubMedCentralCrossRefPubMed
26.
go back to reference Mitsuyama K, Sata M, Rose-John S: Interleukin-6 trans-signaling in inflammatory bowel disease. Cytokine Growth Factor Rev. 2006, 17: 451-461. 10.1016/j.cytogfr.2006.09.003.CrossRefPubMed Mitsuyama K, Sata M, Rose-John S: Interleukin-6 trans-signaling in inflammatory bowel disease. Cytokine Growth Factor Rev. 2006, 17: 451-461. 10.1016/j.cytogfr.2006.09.003.CrossRefPubMed
27.
go back to reference Cahill CM, Rogers JT: Interleukin (IL) 1beta induction of IL-6 is mediated by a novel phosphatidylinositol 3-kinase-dependent AKT/IkappaB kinase alpha pathway targeting activator protein-1. J Biol Chem. 2008, 283: 25900-25912. 10.1074/jbc.M707692200.PubMedCentralCrossRefPubMed Cahill CM, Rogers JT: Interleukin (IL) 1beta induction of IL-6 is mediated by a novel phosphatidylinositol 3-kinase-dependent AKT/IkappaB kinase alpha pathway targeting activator protein-1. J Biol Chem. 2008, 283: 25900-25912. 10.1074/jbc.M707692200.PubMedCentralCrossRefPubMed
29.
go back to reference Ringwood L, Li L: The involvement of the interleukin-1 receptor-associated kinases (IRAKs) in cellualr signaling networsk controlling inflammation. Cytokine. 2008, 42: 1-7. 10.1016/j.cyto.2007.12.012.PubMedCentralCrossRefPubMed Ringwood L, Li L: The involvement of the interleukin-1 receptor-associated kinases (IRAKs) in cellualr signaling networsk controlling inflammation. Cytokine. 2008, 42: 1-7. 10.1016/j.cyto.2007.12.012.PubMedCentralCrossRefPubMed
30.
go back to reference Perry LL, Feilzer K, Caldwell HD: Neither interleukin-6 nor inducible nitric oxide syntahse is required for clearance of Chlamydia trachomatis from the murine genital tract epithelium. Infect Immun. 1998, 66: 1265-1269.PubMedCentralPubMed Perry LL, Feilzer K, Caldwell HD: Neither interleukin-6 nor inducible nitric oxide syntahse is required for clearance of Chlamydia trachomatis from the murine genital tract epithelium. Infect Immun. 1998, 66: 1265-1269.PubMedCentralPubMed
31.
go back to reference Darville T, Andrews CW, Sikes J, Fraley PL, Rank RG: Early local cytokine profiles in strains of mice with different outcomes from chlamydial genital tract infection. Infect Immun. 2001, 69: 3556-3561. 10.1128/IAI.69.6.3556-3561.2001.PubMedCentralCrossRefPubMed Darville T, Andrews CW, Sikes J, Fraley PL, Rank RG: Early local cytokine profiles in strains of mice with different outcomes from chlamydial genital tract infection. Infect Immun. 2001, 69: 3556-3561. 10.1128/IAI.69.6.3556-3561.2001.PubMedCentralCrossRefPubMed
32.
go back to reference Yilma AN, Singh SR, Fairley SJ, Taha MA, Dennis VA: The anti-inflammatory cytokine, interleukin-10, inhibits inflammatory mediators in human epithelial cells and mouse macrophages exposed to live and UV-inactivated Chlamydia trachomatis. Mediators Inflamm. 2012, 2012: 520174-PubMedCentralCrossRefPubMed Yilma AN, Singh SR, Fairley SJ, Taha MA, Dennis VA: The anti-inflammatory cytokine, interleukin-10, inhibits inflammatory mediators in human epithelial cells and mouse macrophages exposed to live and UV-inactivated Chlamydia trachomatis. Mediators Inflamm. 2012, 2012: 520174-PubMedCentralCrossRefPubMed
33.
go back to reference Gupta R, Srivastava P, Vardhan H, Salhan S, Mittal A: Host immune responses to chlamydial inclusion membrane proteins B and C in Chlamydia trachomatis infected women with or without fertility disorders. Reprod Biol Endocrinol. 2009, 7: 38-43. 10.1186/1477-7827-7-38.PubMedCentralCrossRefPubMed Gupta R, Srivastava P, Vardhan H, Salhan S, Mittal A: Host immune responses to chlamydial inclusion membrane proteins B and C in Chlamydia trachomatis infected women with or without fertility disorders. Reprod Biol Endocrinol. 2009, 7: 38-43. 10.1186/1477-7827-7-38.PubMedCentralCrossRefPubMed
Metadata
Title
The IL-6 response to Chlamydia from primary reproductive epithelial cells is highly variable and may be involved in differential susceptibility to the immunopathological consequences of chlamydial infection
Authors
Kelly Cunningham
Scott H Stansfield
Pooja Patel
Shruti Menon
Vivian Kienzle
John A Allan
Wilhelmina M Huston
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Immunology / Issue 1/2013
Electronic ISSN: 1471-2172
DOI
https://doi.org/10.1186/1471-2172-14-50

Other articles of this Issue 1/2013

BMC Immunology 1/2013 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.