Serial circulating concentrations of c‐reactive protein, interleukin (il)‐4, and il‐6 in patients with acute left heart decompensation

Sato, Yukihito; Takatsu, Yoshiki; Kataoka, Kazunori; Yamada, Toshiaki; Taniguchi, Ryoji; Sasayama, Shígetake; Matsumori, Akira

doi:10.1002/clc.4960221211

Cited by 140 publications

(84 citation statements)

References 9 publications

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“…Moreover, we showed that ANP markedly inhibited TNF-␣ production and increased IL-10 production by DCs, which might have some contribution to restoration of the balance of cytokine production and to the control of inflammatory responses in cardiovascular disorders. Consistent with this result, high plasma levels of Th2 cytokines such as IL-4, IL-6, and IL-10 have been observed in patients with CHF (19,43), which may be relevant to our data that ANP itself polarizes DCs toward a Th2-promoting phenotype.…”

Section: Discussionsupporting

confidence: 91%

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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Section: Discussionsupporting

confidence: 91%

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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“…Heart failure is characterized by activation of pro-inflammatory cytokines TNF-a and IL-6 and elevation of C-reactive protein [5,6]. C-reactive protein is an acute-phase protein which, due to its binding specificity for phosphocholine present in a large variety of molecules, recognizes a range of pathogenic targets including membranes of apoptotic and reactive cells [7].…”

Section: Introductionmentioning

confidence: 99%

“…However, these cytokines are elevated in patients with other cardiomyopathies. As this inflammatory marker is associated with adverse prognosis in patients with idiopathic dilated cardiomyopathy [5,6,11], we investigated whether levels of plasma C-reactive protein and IL-6 at baseline could predict clinical outcome in patients with PPCM. In chronic heart failure, low levels of total cholesterol have been found to be a predictor of impaired survival.…”

Section: Introductionmentioning

confidence: 99%

Inflammatory Markers-Serum Level of C-Reactive Protein, Tumor Necrotic Factor-α, and Interleukin-6 as Predictors of Outcome for Peripartum Cardiomyopathy

Sarojini

Shanker

Anitha

2013

J Obstet Gynecol India

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Aim/Objective Peripartum cardiomyopathy (PPCM) is a disorder of unknown etiology in which symptoms of heart failure occur between the last month of pregnancy and 5 months post-partum. These findings prompted us to carry out a more detailed study aimed at correlating plasma levels of C-reactive protein TNF-a and IL-6 as prognostic value for major clinical in-hospital events and 6-month follow-up in patients with PPCM. Materials and Methods After ethical clearance, in the present prospective case-control study, a total of 86 subjects were enrolled [patients (n = 46) and controls (n = 40)]. After checking for the inclusion and exclusion criteria, informed consent was obtained and patients were enrolled. The details of history of pre-eclampsia and mode of delivery were obtained from the patients. The history of onset of symptoms and signs was recorded at the first presentation and at 6 months. Clinical assessment, echocardiography, and blood analysis were done at baseline and after 6 months of standard therapy. All patients received treatment with diuretics and the ACE inhibitor (ramipril), Carvedilol if not contraindicated, and inotropic support inj-Dobutamine. Inflammatory markers (C-reactive protein, TNF-a, and IL-6) were measured at baseline and at 6 months. Data were analyzed using the SAS version 9.1 statistical program. Results The characteristics of the study population at first presentation to the cardiac clinic are similar (compared with controls): 0.91 % of the study patients were diagnosed as PPCM patients for the first time and 49 % patients presented within one month after delivery. C-reactive protein (22 vs 08 mg/dl, p \ 0.05), TNF-a (9.6 vs 3.2 pg/dl, p \ 001), and IL-6 (73.19 ± 34.4 vs 31.52 ± 8.83 pg/dl, p \ 0.005) were significantly abnormal, and these patients showed significantly higher LV dimensions, LV EDD (61.6 ± 7.1 vs 46 ± 9 mm p \ 0.004) LV ESD (53.1 ± 7 vs 32 ± 8, p \ 0.005), and significantly lower echocardiographic left ventricular ejection fraction (LVEF) (25.9 ± 8.2 vs 55 ± 12 p \ 0.001) and correlate well with NYHA FC and death. LVEF improved from 25.9 ± 8.2 to 42.9 ? 13.6 % at 6 months (p \ 0.0001). Patients who completed 6 months of standard care showed a significant reduction of heart rate, LV dimensions, and NYHA FC (p \ 0.001). However, normalization of LVEF ([50 %) was only observed in 11 (35 %) patients. Seven patients died within 6 months of diagnoses and eight patients were lost to follow-up. Conclusions Plasma markers of inflammation were significantly elevated in PPCM patients and correlated with increased LV dimensions and lower EF at presentation. Baseline CRP, IL-6, TNF-a, and higher NYHA FC were the only predictors of mortality. These results contribute to inflammation which may contribute to the pathogenesis of PPCM and its complications and predictors of mortality.

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“…Elevated circulating levels of IL6 have been demonstrated in HF patients, and their serum level expression in cardiac tissue has been correlated with severity of left ventricular function and progression of HF 27 . IL6 has a negative inotropic effect as a consequence of an IL6-induced myocardium hypocontractile state, which explains why patients with uncompensated HF have higher IL6 levels than patients in the recovery phase 28 , reflecting the hemodynamic deterioration in HF patients 29 . In the present paper, even though IL6 levels were elevated in 48% of patients, they were not associated with seropositivity or with higher degrees of HF.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Trypanosoma cruzi antibodies and inflammatory markers in uncompensated heart failure

Bravo-Tobar

Parra²,

Pérez

et al. 2011

Rev. Soc. Bras. Med. Trop.

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Introduction: Heart failure (HF) represents the final stage of chronic chagasic cardiomyopathy (CChC). The diagnosis of CChC is based on the demonstration of anti-Trypanosoma cruzi antibodies (aTcAg) and clinical and epidemiological data. In Venezuela, there are no data about the prevalence of chagasic HF. The aim of this study was to determine the epidemiological, clinical, and inflammatory risk factors associated with seronegative or seropositive HF patients. Methods: We performed a cross-sectional study in the Venezuelan central-west states among a healthy rural population and in patients admitted to the emergency room with uncompensated HF. Results: The seroprevalence rates of Trypanosoma cruzi antibodies were 11.2% and 40.1% in the healthy population and in HF patients, respectively. Seropositivity in healthy individuals was associated with age, knowledge on triatomine vectors, and having seen wild reservoirs in the house; in HF patients, with contact with the vector and previous clinical diagnosis of Chagas' disease; and in both groups taken together, with age, knowledge on triatomines, and HF. Seropositive patients had prolonged QRS, decreased ejection fraction, and high serum magnesium, all significant as compared with HF seronegative cases. Left atrium enlargement and ventricular hypertrophy were most frequently observed in HF seronegative patients. CRP, IL6, ILβ1, IL2, and FNTα were elevated in 94.5%, 48%, 17.8%, 13.7%, and 6.9% of HF patients, respectively, but only IL2 levels were associated with chagasic HF. Conclusions: There is a high prevalence of aTcAg in HF patients from the central-west region of Venezuela, and their epidemiological, clinical, and inflammatory features are discreetly different as compared with those of seronegative cases.

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Serial circulating concentrations of c‐reactive protein, interleukin (il)‐4, and il‐6 in patients with acute left heart decompensation

Cited by 140 publications

References 9 publications

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

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

Inflammatory Markers-Serum Level of C-Reactive Protein, Tumor Necrotic Factor-α, and Interleukin-6 as Predictors of Outcome for Peripartum Cardiomyopathy

Prevalence of Trypanosoma cruzi antibodies and inflammatory markers in uncompensated heart failure

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