Inflammatory Cytokine Production in Patients with Chronic Heart Failure

Systemic inflammatory response syndrome and sepsis have been considered forms of hypercytokinemia in critically ill patients and immunocompromized hosts. It has been reported that some agents, such as antibiotic, PDE-III inhibitors, and adenosine have been known to affect the host's immunological response. We measured plasma cytokine levels (TNF-alpha, IL-1beta and IL-6), and investigated the effect of adenosine can modulate the plasma inflammatory cytokine levels in both patients with chronic heart failure (CHF) and healthy subjects. Methods: We measured plasma levels of the cytokines (TNF-alpha, IL-1beta and IL-6) in 22 CHF patients and 12 healthy controls. Peripheral blood mononuclear cell (PBM) obtained from CHF patients were stimulated by LPS (10 μg/ml) in the absence or the presence of adenosine (10 μmol/l). After 6hr incubation, the cytokines levels in the culture supernatants were measured by ELISA. Results: Plasma levels of TNF-alpha, IL-1beta and IL-6 were significantly greater in patients than in controls. There are no difference among CHF etiology. Adenosine inhibited the generation of all cytokine from LPS-stimulated PBM. Conclusion: These findings suggest that the effectiveness of adenosine may be due to induction of an immunomodulative effect on the host defense systems by regulation of cytokine production.