Serial circulating concentrations of C-reactive protein, interleukin (IL)-4, and IL-6 in patients with acute left heart decompensation
Serial circulating concentrations of C-reactive protein, interleukin (IL)-4, and IL-6 in patients with acute left heart decompensation
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DOI：
10.1002/clc.4960221211
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发表时间：
1999-12-01
影响因子：
2.7
通讯作者：
Matsumori, A
中科院分区：
文献类型：
--
作者：
Sato, Y;Takatsu, Y;Matsumori, A
背景资料：白细胞介素（IL）-6最近已被证明具有负性肌力作用，几项研究报告了这种细胞因子在左心室射血分数降低和慢性左心衰患者中的循环浓度增加。然而，大多数先前的临床研究测量了代偿性慢性心力衰竭中的细胞因子。假设：本研究的目的是检查心肌病和急性心脏失代偿、无感染和不稳定型心绞痛患者的C反应蛋白（CRP）和细胞因子循环浓度的时间演变。方法：CRP，一种抗炎细胞因子白细胞介素（IL）-4，和促炎细胞因子IL-6在8例心肌病和急性心脏代偿失调患者中进行了研究，这些患者没有感染或不稳定型心绞痛。对照样本来自8名年龄匹配的无症状受试者。（2.6 ± 0.8 mg/dl），IL-4（164.6 +/- 36.5 pg/ml）和IL-6（17.1 ± 5.1pg/ml）;这些数值随着心脏代偿失调症状的缓解而显著降低（分别为0.5 +/-0.1mg/dl，77.8 +/-23.6pg/ml，2.3 +/-0.1pg/ml，两者p < 0.05）。结论：在无感染或冠状动脉事件的急性左心失代偿患者中，CRP、IL-4和IL-6升高，并随着心力衰竭症状的缓解而恢复至正常水平。由于心力衰竭患者CRP、IL-4和IL-6浓度的变化是动态的，因此在讨论急性反应蛋白或细胞因子在心力衰竭发病机制中的意义时，代偿和失代偿状态之间的区别很重要。
Background: Interleukin (IL)-6 has recently been shown to have negative inotropic effects, and several studies have reported increases in circulating concentrations of this cytokine in patients with depressed left ventricular ejection fraction and chronic left heart failure. However, most previous clinical studies have measured cytokines in compensated chronic heart failure.Hypothesis: The purpose of this study was to examine the temporal evolution of circulating concentrations of C-reactive protein (CRP) and cytokines in patients with cardiomyopathy and acute cardiac decompensation, free of infection and unstable angina.Methods: The time course of circulating concentrations of CRP, an anti-inflammatory cytokine interleukin (IL)-4, and a proinflammatory cytokine IL-6 were studied in eight patients with cardiomyopathy and acute cardiac decompensation in the absence of infection or unstable angina. Control samples were obtained from eight age-matched asymptomatic subjects.Results: Increased circulating concentrations of CRP (2.6 +/- 0.8 mg/dl), IL-4 (164.6 +/- 36.5 pg/ml), and IL-6 (17.1 +/- 5.1 pg/ml) were found in all eight patients during acute cardiac decompensation; these values decreased significantly with the resolution of symptoms of cardiac decompensation (0.5 +/- 0.1 mg/dl, 77.8 +/- 23.6 pg/ml, 2.3 +/- 0.1 pg/ml, respectively, p < 0.05 for both). There was a significant correlation between peak CRP and peak IL-6 (p < 0.05).Conclusions: In patients with acute left heart decompensation in the absence of infection or coronary events, CRP, IL-4, and IL-6 increased and returned toward normal levels as the symptoms of heart failure resolved. Since the changes in concentrations of CRP, IL-4, and IL-6 in patients with heart failure are dynamic, the distinction between compensated and decompensated state is important when discussing the significance of acute reactive proteins or cytokines in the pathogenesis of heart failure.