Hospital Albert Schweitzer, Department of Adult Medicine, Deschapelles, Haiti.
Expert Opin Ther Targets. 2010 Sep;14(9):895-8. doi: 10.1517/14728222.2010.511181.
Acute peripartum cardiomyopathy, a unique form of heart failure with onset in the last phase of pregnancy or shortly postpartum, has demonstrated evidence of an inflammatory process characterized by cytokine imbalance. Cytokines serve as inducers of repair mechanisms and promoters of both inflammatory and anti-inflammatory immune responses. Elevated plasma C-reactive protein, a marker of an inflammatory process, is co-expressed in the heart with the pro-inflammatory cytokine, TNF-alpha. Both pro-inflammatory and anti-inflammatory cytokines are involved in an intricate balance in response to injury to the heart. This article discusses potential and identified imbalances in levels of cytokines in peripartum cardiomyopathy that have led to clinical trials aimed at the modulation of select number of cytokines, some of which have been shown to have significant clinical benefit. Continuing investigation in this area is important since restoration of critical cytokine balance may be an area that holds promise for therapy. At the same time, one must be cautious in the timing of any intervention that alters cytokine balance.
急性围生期心肌病，一种发生于妊娠末期或产后不久的心力衰竭的独特形式，其发病机制已被证实与炎症过程有关，该过程的特征为细胞因子失衡。细胞因子作为修复机制的诱导物和促炎及抗炎免疫反应的促进剂。升高的血浆 C 反应蛋白是炎症过程的标志物，与促炎细胞因子 TNF-α在心脏中共同表达。在心脏损伤的情况下，促炎和抗炎细胞因子参与复杂的平衡反应。本文讨论了围生期心肌病中细胞因子水平的潜在和已确定的失衡，这些失衡导致了针对特定细胞因子的调节的临床试验，其中一些已经显示出显著的临床获益。在该领域继续进行研究非常重要，因为恢复关键细胞因子平衡可能是治疗的一个有前途的领域。同时，人们必须谨慎对待任何可能改变细胞因子平衡的干预措施的时机。
