Effect of beta-blockers on circulating levels of inflammatory and anti-inflammatory cytokines in patients with dilated cardiomyopathy
Effect of beta-blockers on circulating levels of inflammatory and anti-inflammatory cytokines in patients with dilated cardiomyopathy
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DOI：
10.1016/s0735-1097(00)01121-9
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发表时间：
2001-02-01
影响因子：
24
通讯作者：
Hiwada, K
中科院分区：
文献类型：
--
作者：
Ohtsuka, T;Hamada, M;Hiwada, K
目的 本研究旨在评估 β 受体阻滞剂对扩张型心肌病 (DCM) 患者循环细胞因子水平的有益作用。背景 据报道，DCM 患者循环炎症细胞因子水平升高。然而，与β受体阻滞剂治疗相关的炎症和抗炎细胞因子水平的变化尚不清楚。方法我们研究了32名特发性扩张型心肌病患者，他们接受过洋地黄、利尿剂和血管紧张素转换酶抑制剂治疗。除了这种联合治疗外，所有患者都开始服用β受体阻滞剂。在基线和开始 β 受体阻滞剂治疗后 12 周测量白细胞介素 (IL)-10、肿瘤坏死因子-α (TNF-α) 和可溶性 TNF 受体（sTNF-R1 和 R2）的血清水平。我们还测量了神经体液因子的血浆水平以及左心室 (LV) 大小和功能。十名年龄匹配、无心脏病的受试者作为对照组。结果 DCM 患者的 IL-10、TNF-α 和 sTNF-R2 基线水平显着高于对照组（p < 0.05）。 IL-10 和 TNF-α 水平之间存在显着正相关（r = 0.545，p = 0.029）。 TNF-α/IL-10比值与血浆肾上腺素水平密切相关（r = 0.677，p = 0.025），sTNF-R2水平与左室大小密切相关。 β-受体阻滞剂治疗期间，IL-10、TNF-α 和 sTNF-R2 的血清水平显着降低 (p < 0.005)。 结论 我们的研究结果表明，β-受体阻滞剂在改变 DCM 失调的细胞因子网络方面具有重要的免疫调节作用。 β受体阻滞剂的这种作用可能是心力衰竭治疗药物疗效的部分原因。 (C) 2001 年由美国心脏病学会发布。
Objectives This study was designed to evaluate the beneficial effect of beta-blockers on circulating cytokine levels in patients with dilated cardiomyopathy (DCM).Background Elevated circulating levels of inflammatory cytokines have been reported in patients with DCM. However, alterations of the levels of inflammatory and anti-inflammatory cytokines in association with beta-blocker therapy are unknown.Methods We studied 32 patients with idiopathic DCM who had been treated with digitalis, diuretics and angiotensin-converting enzyme inhibitors. In addition to this combination therapy, beta-blockers were started in all patients. Serum levels of interleukin (IL)-10, tumor necrosis factor-alpha (TNF-alpha) and soluble TNF receptors (sTNF-R1 and R2) were measured at baseline and 12 weeks after the initiation of beta-blocker therapy. We also measured plasma levels of neurohumoral factors, as well as left ventricular (LV) size and function. Ten age-matched subjects with no cardiac disease served as the control group.Results Baseline levels of IL-10, TNF-alpha and sTNF-R2 were significantly higher in patients with DCM than in control subjects (p < 0.05). There was a significant positive correlation between IL-10 and TNF-alpha levels (r = 0.545, p = 0.029). The TNF-alpha/IL-10 ratio correlated well with plasma epinephrine levels (r = 0.677, p = 0.025), and the level of sTNF-R2 was closely related to LV size. Serum levels of IL-10, TNF-alpha and sTNF-R2 were significantly decreased during beta-blocker therapy (p < 0.005).Conclusions Our findings indicate that beta-blockers have an important immunoregulatory role in modifying the dysregulated cytokine network in DCM. This effect of beta blockers may be partly responsible for the efficacy of therapeutic drugs for heart failure. (C) 2001 by the American College of Cardiology.