In addition to viral infections, oxygen deprivation can also damage the heart tissue and lead to heart failure – a condition that affects roughly 40,000 people each year in the Netherlands alone. When heart damage occurs, the body's immune system is automatically engaged to minimise the damage by creating inflammation.

Inflammation
How exactly this inflammation develops is unclear. In order to improve treatment, it's important that we gain a better understanding of this process. Current therapies to treat heart failure only address the symptoms and not the underlying cause. Rienks discovered three proteins that play an important role in the inflammation process and shed new light on the development of heart failure. These proteins may be a great starting point for the development of new medications.

Discovery
When a virus damages the heart, it causes cardiac muscle cells to die off. The body replaces these cells with scar tissue, as it's not capable of generating new cardiac cells. Eventually, this leads to reduced pump function and heart failure. Rienks found that three proteins were activated during the inflammation process. The first (osteoglycine) acts as a kind of alarm for the immune system and signals that damage has occurred. The second protein (glycoprotein SPARC) is found in the blood vessels and prompts the body's immune system to send white blood cells to the site of the infection. The last protein (semaphorin-3A) ensures that the inflammatory response is stopped; if the immune system stays active for too long, it can cause damage.

Development
Although the research is fundamental in nature, it could have important implications for the development of clinical treatment options. 'This study helped to solve another piece of the heart failure puzzle,' says Rienks. 'It's important to understand the heart's biological processes before developing a therapy in the lab that can be offered to patients.'

Marieke Rienks is affiliated with the CARIM research institute and will receive her PhD from Maastricht University on Friday 26 February for her dissertation titled: 'Secreted Glycoproteins and Proteoglycans Orchestrate Inflammation in Cardiac Disease'. Rienks is also one of the Faces of Science of the Royal Netherlands Academy of Arts and Sciences (KNAW).