Levels of TNF-α and Soluble TNF Receptors in Normal-Weight, Overweight and Obese Patients with Dilated Non-Ischemic Cardiomyopathy: Does Anti-TNF Therapy Still Have Potential to Be Used in Heart Failure Depending on BMI?

Abstract

Background. We sought to measure the levels of adipokines, TNF-α and soluble receptors (sTNFr1, sTNFr2) in heart failure patients with reduced ejection fraction (HFrEF) due to non-ischemic cardiomyopathy (nDCM). Methods. A total of 123 patients with HFrEF due to nDCM were divided into three groups according to BMI: 34 (27.6%) normal weight, 56 (45.5%) overweight and 33 (26.8%) obese. A six-minute walk test, echocardiography and right heart catheterization were performed. Serum concentrations of adiponectin, leptin, NT-proBNP, blood hemoglobin, sodium, creatinine, ALAT, AspAT, bilirubin, CRP, lipids, TNF-α, sTNFr1 and sTNFr2 receptors were measured. Results. Obese patients had the lowest NT-proBNP concentrations, significantly higher leptin levels and higher leptin/adiponectin ratios. The concentration of sTNFr1 was higher in normal-weight patients. In all groups, TNF-α concentrations correlated positively with sTNFr1 (p < 0.001). Higher levels of sTNFr1 were associated with higher sTNFr2 (p < 0.001) and CRP (p < 0.001). Moreover, the concentration of sTNFr2 positively correlated with CRP (p < 0.05) and adiponectin (p < 0.001). Levels of TNF-α were not associated with elevated CRP. Conclusion: This study demonstrated that changes in the concentrations of TNF and its receptors differ between groups of patients with different BMI. These findings suggest that the effective use of anti-TNF therapy is dependent not only on BMI, but also on concentrations of TNF-α receptors and other laboratory parameters.

Alpha-lipoic acid, apocynin or probiotics influence glutathione status and selected inflammatory parameters in C57/BL6 mice when combined with a low-fat diet

“…The combination of high levels of TNF-α with epithelial cell injury may lead to airway remodeling: a common feature of asthma. Several studies have found circulating concentrations of TNF-α to be elevated in obesity [ 22 , 23 ]. Vieira et al [ 24 ] report that elevated collagen levels in the lungs of OVA-challenged C57BL/6 mice were reduced by anti-TNF-α treatment.…”

Circulating biological markers of obesity: towards a systems approach

“…Также уровни рецепторов sTNFr1 и sTNFr2 коррелировали с уровнем СРБ, но только в группе пациентов с нормальным весом, тогда как для уровней самого лиганда ФНО-α статистически значимых различий получено не было. В этом аспекте интересным является мнение авторов работы о перспективности исследования сывороточных уровней рецепторов sTNFr1 и sTNFr2 в качестве биомаркеров воспаления, ассоциированных с ожирением, у больных с дилатационной неишемической кардиомиопатией, а также в качестве предикторов эффективности лечения перед назначением анти-ФНО терапии [36].…”