Cytokine network in congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy

Aukrust, Pål; Ueland, Thor; Lien, Egil; Bendtzen, Klaus; Müller, Fredrik; Andreassen, Arne K.; Nordøy, Ingvild; Aass, Halfdan; Espevik, Terje; Simonsen, Svein; Frøland, Stig S.; Gullestad, Lars

doi:10.1016/s0002-9149(98)00872-8

Cited by 419 publications

(302 citation statements)

References 29 publications

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“…1 Furthermore, increased levels of inflammatory cytokines have been observed in patients with silent myocardial ischemia 16 and in patients with ischemic cardiomyopathy. 17 Hence, it has been suggested that sustained TNF-␣ expression after myocardial infarction and in persistent ischemia may have detrimental effects on the remodeling process. 18 However, recent trials with anticytokine agents such as etanercept and infliximab showed time-and dose-dependent worsening of heart failure.…”

Section: Discussionmentioning

confidence: 99%

Therapy of Ischemic Cardiomyopathy With the Immunomodulating Agent Pentoxifylline

et al. 2004

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Background-Inflammatory immune activation commonly occurs in heart failure and may perpetuate this syndrome. We sought to determine whether the immunomodulating agent pentoxifylline enhances left ventricular function in patients with ischemic cardiomyopathy. We also investigated the effect of therapy on levels of brain natriuretic peptide (NT-pro BNP), C-reactive protein (CRP), tumor necrosis factor-␣ (TNF-␣), and the marker of apoptosis, Fas/Apo-1. Methods and Results-In a single-center, prospective, randomized, double-blind, placebo-controlled study, 38 patients with ischemic cardiomyopathy received pentoxifylline 400 mg TID or placebo in addition to standard therapy. Clinical assessment, radionuclide ventriculography, echocardiography, and blood analyses were performed at baseline and after 6 months. There were no differences in baseline characteristics between the groups. Five patients died (4 in the placebo group). Pentoxifylline treatment resulted in an improvement in functional class (PϽ0.005) and an increase in systolic blood pressure (PϽ0.05) and left ventricular radionuclide ejection fraction (PϽ0.05) compared with the placebo-treated group. There were reductions in plasma concentrations of CRP, NT-pro BNP, TNF-␣, and Fas/Apo-1 in the pentoxifylline compared with the placebo-treated group. Conclusions-In patients with heart failure due to ischemic left ventricular dysfunction, the addition of pentoxifylline to standard therapy results in improvements in clinical status and radionuclide ejection fraction, which are accompanied by reductions in plasma markers of inflammation, prognosis, and apoptosis.

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Section: Discussionmentioning

confidence: 99%

Therapy of Ischemic Cardiomyopathy With the Immunomodulating Agent Pentoxifylline

et al. 2004

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“…CHF and some types of cardiomyopathy with high levels of ANP have recently been recognized as syndromes involving not only cardiovascular dysfunction but also inflammatory process (14 -16). It has been suggested that proinflammatory cytokines such as TNF-␣, IL-1, and IL-6 play important roles in development of these disorders (14,16). In particular, TNF-␣ presumably produced by activated macrophages and vascular endothelial cells has been shown to aggravate the hemodynamics of CHF (14,16).…”

Section: Discussionmentioning

confidence: 99%

“…It has been suggested that proinflammatory cytokines such as TNF-␣, IL-1, and IL-6 play important roles in development of these disorders (14,16). In particular, TNF-␣ presumably produced by activated macrophages and vascular endothelial cells has been shown to aggravate the hemodynamics of CHF (14,16). As has been mentioned, clinical studies have demonstrated that targeted anti-TNF-␣ therapy with recombinant TNF-␣ receptor improves the functional status of patients with CHF (18).…”

Section: Discussionmentioning

confidence: 99%

Atrial Natriuretic Peptide Polarizes Human Dendritic Cells Toward a Th2-Promoting Phenotype Through Its Receptor Guanylyl Cyclase-Coupled Receptor A

Morita

Ukyo

Furuya

et al. 2003

The Journal of Immunology

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Atrial natriuretic peptide (ANP) is a cardiovascular hormone secreted mainly by the cardiac atria and regulates the volume-pressure homeostasis. The action of ANP is mediated by its receptor, guanylyl cyclase-coupled receptor A (GC-A). In this study, we explored the possibility that ANP and GC-A may play a role in the dendritic cell (DC)-mediated immune regulation. We first examined the expression of GC-A in human monocyte-derived DCs in comparison with monocytes and found that DCs but not monocytes express GC-A at both the mRNA and protein levels. DCs responded to ANP with an increase in intracellular cGMP in a dose-dependent manner, indicating that GC-A expressed on DCs is functional. Furthermore, treatment of DCs with ANP decreased production of IL-12 and TNF-α and conversely increased that of IL-10 upon stimulation with LPS. In accordance with this change of cytokine production, DCs treated with ANP plus LPS promoted differentiation of naive CD4+ T cells into a Th2 phenotype. Finally, we presented evidence that ANP affected cytokine production of fresh whole blood stimulated with LPS in line with the above-mentioned results. These results indicate that ANP polarizes human DCs toward a Th2-promoting phenotype through GC-A and thus can regulate immune responses.

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“…There is an elevation in the serum TNF-α concentration and this is associated with the functional class of the patient. Additionally, there is evidence that the cytokines may contribute to the progression of arteriosclerosis [18,19].…”

Section: Commentsmentioning

confidence: 99%

Reconstrução fisiológica do ventrículo esquerdo: o conceito de máxima redução ventricular e mínima resposta inflamatória

Gomes¹,

Jaramillo²,

Asanuma³

et al. 2004

Rev Bras Cir Cardiovasc

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Cytokine network in congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy

Cited by 419 publications

References 29 publications

Therapy of Ischemic Cardiomyopathy With the Immunomodulating Agent Pentoxifylline

Therapy of Ischemic Cardiomyopathy With the Immunomodulating Agent Pentoxifylline

Atrial Natriuretic Peptide Polarizes Human Dendritic Cells Toward a Th2-Promoting Phenotype Through Its Receptor Guanylyl Cyclase-Coupled Receptor A

Reconstrução fisiológica do ventrículo esquerdo: o conceito de máxima redução ventricular e mínima resposta inflamatória

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