Multiple Myeloma Complicated by Congestive Heart Failure Following First Administration of Recombinant .ALPHA.-Interferon.

Kobayashi, Tetsuhiko; Sato, Yuji; Hasegawa, Yoshinori; Nagasawa, Toshiro; Yoda, Yasuhiro; Abe, Tsukasa

doi:10.2169/internalmedicine.31.936

Cited by 12 publications

(4 citation statements)

References 18 publications

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“…Moreover, type I IFNs have been linked to atherosclerosis progression and vascular damage in both murine models [17] and human patients [41]–[43], thus proposing a type I IFN-mediated pathogenic role in CV disease in autoimmune patients. In addition, IFNα pharmacological treatment in non-RA subjects has been associated with CV disease [44], [45]. The increased rate of CV events in IFN high patients reported in our study support these findings.…”

Section: Discussionsupporting

confidence: 88%

IFNα Serum Levels Are Associated with Endothelial Progenitor Cells Imbalance and Disease Features in Rheumatoid Arthritis Patients

et al. 2014

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IntroductionIFNα has been largely implicated in the ethiopathogenesis of autoimmune diseases but only recently it has been linked to endothelial damage and accelerated atherosclerosis in autoimmunity. In addition, proinflammatory conditions are supposed to be implicated in the cardiovascular status of these patients. Since a role for IFNα in endothelial damage and impaired Endothelial Progenitor Cell (EPC) number and function has been reported in other diseases, we aimed to evaluate the potential associations of IFNα serum levels on EPC populations and cytokine profiles in Rheumatoid Arthritis (RA) patients.Methodspre-EPC, EPC and mature EPC (mEPC) populations were quantified by flow cytometry analyzing their differential CD34, CD133 and VEGFR2 expression in blood samples from 120 RA patients, 52 healthy controls (HC), and 83 systemic lupus erythematosus (SLE) patients as disease control. Cytokine serum levels were measured by immunoassays and clinical and immunological data, including cardiovascular (CV) events and CV risk factors, were retrospectively obtained by reviewing clinical records.ResultsLong-standing, but not recent onset RA patients displayed a significant depletion of all endothelial progenitor populations, unless high IFNα levels were present. In fact, the IFNhigh RA patient group (n = 40, 33%), showed increased EPC levels, comparable to SLE patients. In addition, high IFNα serum levels were associated with higher disease activity (DAS28), presence of autoantibodies, higher levels of IL-1β, IL-6, IL-10 and MIP-1α, lower amounts of TGF-β, and increased mEPC/EPC ratio, thus suggesting higher rates of endothelial damage and an endothelial repair failure. Finally, the relationship between high IFNα levels and occurrence of CV events observed in RA patients seems to support this hypothesis.ConclusionsIFNα serum marker could be used to identify a group of RA patients with increased disease activity, EPC imbalance, enhanced proinflammatory profile and higher cardiovascular risk, probably due, at least in part, to an impaired endothelial repair.

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Section: Discussionsupporting

confidence: 88%

IFNα Serum Levels Are Associated with Endothelial Progenitor Cells Imbalance and Disease Features in Rheumatoid Arthritis Patients

et al. 2014

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“…Similar observations of severe cardiovascular complications, including myocardial infarction, have been reported in patients treated with IFN because of the hepatitis C virus 11. The onset of cardiac symptoms after IFN administration varies from minutes to a few hours, as was the case with our patient and as has been reported in a patient with multiple myeloma who developed congestive heart failure 16 hours after the administration of IFN 12…”

Section: Discussionsupporting

confidence: 83%

The effect of interferon on mouse myocardial capillaries

Salman

Bergman

Bessler

et al. 1999

Cancer

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BACKGROUND Cardiotoxicity, including ischemia and myocardial infarction, is one of the complications observed after treatment with interferon (IFN). Therefore, the question has been raised whether IFN may cause damage to the small myocardial blood vessels. METHODS In this study, 400 U of IFN‐α‐2b per g of body weight were injected intraperitoneally into 2 groups of C57 Bl mice, 5 days a week for 3 and 5 months, respectively. Thin sections of the myocardium were examined with a transmission electron microscope and the ultrastructure of the capillaries was compared with that of control animals. RESULTS The results showed a statistically significant increase in the thickness of the endothelial processes of the myocardial capillary walls in the mice treated with IFN, with a subsequent decrease in the size of the capillary lumen. The entire capillary area was not affected. CONCLUSIONS These findings may serve as an additional explanation for the cardiac complications observed in patients treated with IFN. Cancer 1999;85:1375–9. © 1999 American Cancer Society.

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“…Various mechanisms that may explain cardiovascular adverse effect of IFN have been proposed. They include the inhibition of neogenesis of muscle‐contracting protein, an autoimmune reaction, increased demand for oxygen and coronary vasospasm, but none has been proven [1,9].…”

Section: Discussionmentioning

confidence: 99%

Cardiac arrhythmia induced by interferon beta‐1a

Kastalli¹,

Aidli²,

Mourali

et al. 2011

Fundamemntal Clinical Pharma

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Cardiac adverse effects have never been reported with interferon (INF) beta. We report a case of left bundle branch block in a 35-year-old woman treated with INF beta-1a for multiple sclerosis. Five years after INF therapy, she presented loss of consciousness, retrosternal pains, short breath and lowered tolerance of effort. ECG and Holter 24-h ECG monitoring revealed permanent complete left bundle branch block. Nine months after stopping INF, no abnormalities were found at ECG and echocardiogram examination.

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Multiple Myeloma Complicated by Congestive Heart Failure Following First Administration of Recombinant .ALPHA.-Interferon.

Cited by 12 publications

References 18 publications

IFNα Serum Levels Are Associated with Endothelial Progenitor Cells Imbalance and Disease Features in Rheumatoid Arthritis Patients

IFNα Serum Levels Are Associated with Endothelial Progenitor Cells Imbalance and Disease Features in Rheumatoid Arthritis Patients

The effect of interferon on mouse myocardial capillaries

Cardiac arrhythmia induced by interferon beta‐1a

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