[Cytokine networks and their endogenous modulators in patients with congestive heart failure].

OBJECTIVE

To explore the pathophysiological role of cytokine network and their endogenous modulators in the development of congestive heart failure (CHF).

METHODS

Plasma levels of tumor necrosis factor-alpha (TNF-alpha), interleukin-6(IL-6), soluble TNF receptor I (sTNF-RI) and transforming growth factor (TGF)-beta were measured by enzyme-linked immunoassay in 52 CHF patients with various degrees of heart failure and in 30 healthy controls.

RESULTS

Patients with CHF had increased plasma concentrations of TNF alpha, IL-6 and sTNF-RI, but decreased levels of TGF-beta. They also had elevated ratios of TNF-alpha/sTNF-RI and TNF-alpha/TGF-beta, particularly those in functional class IV. The levels of TNF-alpha were positively correlated with IL-6 and sTNF-RI but negatively correlated with TGF-beta(P < 0.01).

CONCLUSIONS

The imbalance in the cytokine network were most pronounced in patients with the most severe heart failure. CHF may be accompanied by a shift toward enhanced levels of inflammatory cytokines combined with inadequately raised or even decreased levels of anti-inflammatory cytokines. A poorly regulated cytokine network may be involved in the development and progression of CHF.