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AmJCaseRep

Anti-inflammatory strategies in heart failure

Agata Bielecka-Dąbrowa, Magdalena Wierzbicka, Aleksander Goch

Med Sci Tech 2007; 48(3): RP141-145

ID: 881559

Available online:

Published: 2007-03-20


Introduction: The inflammatory factors are key elements of immune activation. Several studies have shown raised levels of not only TNF-alpha, but also IL-l beta and IL-6 and the others in HF (heart failure) patients. This rise in inflammatory mediators does not seem to be accompanied by a corresponding increase in anti-inflammatory cytokines such as IL-10 and transforming growth factor-beta; thus resulting in an inflammatory imbalance in the cytokine network. Several lines of evidence suggest that inflammation plays a pathogenic role in the development and progression of congestive heart failure (CHF), influencing heart contractility and hypertrophy, promoting apoptosis, and contributing to the myocardial remodeling process. Despite complete treatment, CHF is a progressive disease with high mortality and morbidity, suggesting that important pathogenic mechanisms remain active and unmodified by the present treatment modalities. Material and ethods: In this review we present the latest research connected with new anti-inflammatory treatments in heart failure. Results: Traditional cardiovascular drugs have little influence on the cytokine network. Results from randomized, placebo controlled anti - TNF studies suggest lack of effect of such therapy, but the concept of immune modulation is still intensively studied. More general immunomodulating treatments, such as pentoxyfylline and statins and approaches that enhance the natural anti-inflammatory response (eg. intravenous immunoglobulin, immunoadsorption, immune-modulation therapy), have shown promising results in smaller studies. Conclusions: These preliminary findings are consistent with the hypothesis that immune activation is important in the pathogenesis of CHF. The positive results of anti-inflammatory therapies give a chance to modify heart failure therapy using new ways of treatment. The safety and efficiency of these therapies are needed to be confirmed in larger studies with hospitalizations and death as the end points. (Clin Exp Med Lett 2007; 48(3):141-145)

Keywords: Cytokines, Intravenous immunoglobulin, immune-modulation therapy, immunoadsorption



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