Abstract
Background:
Cytokines are important mediators of the immune system and are of pathophysiological relevance for different cardiac diseases. Currently, 18 cytokines carrying the name interleukin (IL) are known; they can be subdivided into pro- and anti-inflammatory interleukins.
Cardiac cytokines:
They partly act in a negative inotropic manner and cause destruction of cardiomyocytes resulting in myocardial fibrosis. The proinflammatory cytokine tumor necrosis factor (TNF-)alpha induces cardiodepressive effects and causes apoptosis. TNF-alpha, IL-6, soluble TNF-receptor-1 and -2 are independent predictors of increased mortality of patients with heart failure. Experimental and clinical evidence has shown that plasma and tissue levels of TNF-alpha were elevated to such extent as to explain at least some of the symptoms of heart failure due to the actions of this cytokine.
Clinical trials:
Two multicenter studies (RENAISSANCE, RECOVER), based on promising pilot studies, have disclosed no effect for the TNF-alpha antagonists (Etanercept) on mortality and morbidity. It is not possible, however, to draw the conclusion from the data of these studies that TNF-alpha plays no significant pathophysiological role in the etiology and progression of heart failure.
Publication types
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Comparative Study
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English Abstract
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Review
MeSH terms
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Animals
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Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
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Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
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Antibodies, Monoclonal / adverse effects
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Antibodies, Monoclonal / therapeutic use
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Cardiomyopathy, Dilated / drug therapy
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Cardiomyopathy, Dilated / etiology
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Clinical Trials, Phase II as Topic
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Cytokines / antagonists & inhibitors*
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Cytokines / blood
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Cytokines / physiology*
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Double-Blind Method
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Etanercept
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Follow-Up Studies
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Heart Failure / blood
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Heart Failure / complications
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Heart Failure / drug therapy*
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Heart Failure / etiology*
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Heart Failure / mortality
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Heart Failure / physiopathology
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Humans
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Immunoglobulin G / administration & dosage
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Immunoglobulin G / therapeutic use
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Infliximab
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Infusions, Intravenous
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Injections, Subcutaneous
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Interleukin-6 / blood
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Interleukins / blood
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Interleukins / physiology
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Mice
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Molecular Weight
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Multicenter Studies as Topic
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Pentoxifylline / administration & dosage
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Pentoxifylline / therapeutic use
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Placebos
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Prognosis
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Randomized Controlled Trials as Topic
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Receptors, Tumor Necrosis Factor / administration & dosage
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Receptors, Tumor Necrosis Factor / physiology
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Receptors, Tumor Necrosis Factor / therapeutic use
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Survival Analysis
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Time Factors
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Transcription Factors / physiology
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Tumor Necrosis Factor-alpha / analysis
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Tumor Necrosis Factor-alpha / antagonists & inhibitors
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Tumor Necrosis Factor-alpha / physiology
Substances
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Anti-Inflammatory Agents, Non-Steroidal
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Antibodies, Monoclonal
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Cytokines
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Immunoglobulin G
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Interleukin-6
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Interleukins
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Placebos
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Receptors, Tumor Necrosis Factor
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Transcription Factors
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Tumor Necrosis Factor-alpha
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Infliximab
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Etanercept
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Pentoxifylline