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ESC William Harvey Lecture on Basic Science Modifiable risk factors and cardiovascular disease

To the presenter of this year’s William Harvey Lecture, Professor Filip Swirski (Massachusetts General Hospital, Boston, MA, USA), the human immune system is an intricate and beautiful thing.

Basic Science

Professor of Radiology at Harvard Medical School, Faculty Member of Harvard Medical School’s PhD Program in Immunology and Member of Harvard Medical School’s Division of Sleep Medicine, Prof. Swirski has spent 15 years exploring immune and inflammatory mechanisms in cardiovascular disease (CVD). His contributions have had a major impact on our understanding of inflammation in atherosclerosis and its complications.1

“Researching at the intersection of the immune and cardiovascular systems has highlighted just how well these systems work in partnership. Our research has extended understanding of how specific immune cells – monocytes and macrophages – participate in an extraordinarily important way in atherosclerosis, a disease which is really the root cause of the most deaths worldwide,” he explained.

Prof. Swirski’s William Harvey Lecture discussed a number of risk factors for CVD that have the potential to be altered. “There’s no question that genetics have a role in heart disease,” he said. “But we also know that there are specific lifestyle factors – diet, exercise, stress and sleep – that are crucially important. The motivation behind our research is to try to understand the molecular basis of how specific lifestyles either protect against or contribute to disease.”

The implications of his research spread beyond CVD. This, explained Prof. Swirski, is due to the increasingly recognised interconnectedness of the systemic inflammatory networks with other physiological systems. He used sleep, currently a major interest in his research, as an example. “We know we need sleep, but we don’t really know why. Identifying the processes by which sleep protects us and, conversely, how sleep disruption elevates cardiovascular risk, may help to identify potentially druggable pathways that might be relevant to many processes, not just those involving sleep,” he said.

This research is vital in informing how an individual’s environment can be adapted to modify risk factors and also in shaping policy and culture about healthy lifestyle choices. The importance of the interconnections between the immune system and other systems, and how they respond to each other and the environment, will be a leading theme of future research, thinks Prof. Swirski.

Applying the findings from the type of research he conducts is quite a challenge. “We need to simplify the complexity of these systems if we are to use the information to develop new therapeutics or alter policy making,” said Prof. Swirski, continuing, “We also need to find better ways to translate findings from experimental systems to human biology. We have already seen a tremendous development of tools to help make those translational connections and the future will undoubtedly bring new technologies to help overcome these hurdles.”

With his enthusiasm and motivation, Prof. Swirski is ready for such challenges. “There is no doubt that the more research you do, the more there is to learn. Every good paper you read answers some questions, but inevitably raises more. This is very much the nature of research and it is what makes it so enjoyable and rewarding.”


1. Swirski FK, et al. J Clin Invest 2007;117:195–204.

The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.