Gene expression and levels of IL-6 and TNFα in PBMCs correlate with severity and functional class in patients with chronic heart failure.

Abstract

Evidence shows that proinflammatory cytokines are important determinants of assessment of severity and prognosis of chronic heart failure (CHF). We investigated whether peripheral expression of the proinflammmatory factors, TNF-α and IL-6 can predict variable of clinical assessment of patients with CHF. In this report, we used real-time PCR assay to compare relative gene expression of TNFα and IL-6 in PBMC from CHF patients with various heart diseases (n=42, EF<45%, NYHA I to IV) and matched healthy control subjects (n=42).We also determined the TNFα and IL-6 concentrations of cell culture supernatant of PBMCs with ELISA. There was a significant negative correlation between gene expression of TNFα and LVEF(r=0.4, p<0.05). Patients with CHF had increased gene expression of TNFα and IL-6 in PBMCs (p<0.05). They also had elevated the supernatant levels of these cytokines in cultured PBMCs (p<0.001). Levels of TNFα and IL-6 were increased in ischemic heart disease compared to non-ischemic heart disease. There was a positive correlation between TNFα and IL-6 levels in CHF patients and severity of CHF in patients. Levels of these cytokines were higher in patients with NYHA III-IV than in NYHA I-II and normal subjects. Results of this study indicate that peripheral expression of proinflammatory cytokines, TNF-α and IL-6, is important indicators of severity and prognosis in patients with chronic heart disease.