Circulating levels of interleukin 18 reflect etiologies of heart failure: Th1/Th2 cytokine imbalance exaggerates the pathophysiology of advanced heart failure
Circulating levels of interleukin 18 reflect etiologies of heart failure: Th1/Th2 cytokine imbalance exaggerates the pathophysiology of advanced heart failure
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DOI：
10.1054/jcaf.2002.31628
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发表时间：
2002-02-01
影响因子：
6
通讯作者：
Izumi, T
中科院分区：
文献类型：
--
作者：
Yamaoka-Tojo, M;Tojo, T;Izumi, T
背景：促炎因子如肿瘤坏死因子α在CHF的病理生理中起重要作用。然而，CHF的免疫激活机制尚不清楚。白细胞介素(IL)-18是一种新发现的具有多效性的细胞因子，已知可诱导促炎细胞因子、趋化因子、一氧化氮和前列腺素。方法与结果：我们研究了86例纽约心脏协会功能II-IV级心力衰竭患者。平均年龄62岁，女性20例，平均左室射血分数34.8%。测定循环IL-18和rL-10水平、c反应蛋白高灵敏度检测和脑利钠肽水平。NYHA IV级患者血清IL-18浓度显著高于II级和III级患者（P < 0.001）。缺血性心肌病患者血清IL-18水平及IL-18 / IL-10比值高于扩张型心肌病患者。结论：晚期CHF患者存在不同病因的Th1/Th2细胞因子失衡。提示IL-18在CHF的病理生理中发挥重要作用，为更特异性的免疫调节治疗提供方向。
Background: Proinflammatory cytokines such as tumor necrosis factor alpha play an important role in the pathophysiology of CHF. However, the mechanisms of immune activation in CHF remain unknown. Interleukin (IL)-18, a newly discovered cytokine with pleiotropic activities, is known to induce proinflammatory cytokines, chemokines, nitric oxide, and prostaglandins. Methods and Results: We studied 86 patients with New York Heart Association functional class II-IV heart failure. Mean age was 62 years, 20 were women, and mean left ventricular ejection fraction was 34.8%. Circulating levels of IL-18 and rL-10, high-sensitivity testing for C-reactive protein, and brain natriuretic peptide levels were deter-mined. Serum IL-18 concentrations were significantly higher in patients with NYHA class IV than in patients with classes II and III (P < .001). The serum level of IL-18 and the ratio of IL-18 to IL-10 were greater in patients with ischemic cardiomyopathy than in those with dilated cardiomyopathy. Conclusions: Th1/Th2 cytokine imbalance exists in patients with advanced CHF according to various etiologies of CHF. The findings suggest an important role for IL-18 in the pathophysiology of CHF and provide a direction for more specific immunomodulating therapy.