Circulating interleukin-10: Association with higher mortality in systolic heart failure patients with elevated tumor necrosis factor-alpha

Offer Amir, Ori Rogowski, Miriam David, Nitza Lahat, Rafael Wolff, Basil S. Lewis

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Interleukin-10 is an anti-inflammatory cytokine and consequently is considered by many to have a protective role in heart failure, as opposed to the notorious tumor nec-rosis factor-alpha. Objectives: To test the hypothesis of the possible beneficial impact of IL-10 on mortality in systolic heart failure patients in relation to their circulating TNFα levels. Methods: We measured circulating levels of IL-10 and TNFα in 67 ambulatory systolic heart failure patients (age 65 ± 13 years). Results: Mortality was or tended to be higher in patients with higher levels (above median level) of circulating TNFα (9/23, 39% vs. 6/44, 14%; P = 0.02) or IL-10 (10/34, 30% vs. 5/33, 15%; P = 0.10). However, mortality was highest in the subset of patients with elevation of both markers above median (7/16, 44% vs. 8/51, 16%; P = 0.019). Elevation of both markers was associated with more than a threefold hazard ratio for mortality (HR 3.67, 95% confidence interval 1.14-11.78). Conclusions: Elevated circulating IL-10 levels in systolic heart failure patients do not have a protective counterbalance effect on mortality. Moreover, patients with elevated IL-10 and TNFα had significantly higher mortality, suggesting that the possible interaction in the complex inflammatory and anti-inflammatory network may need further study.

Original languageEnglish
Pages (from-to)158-162
Number of pages5
JournalIsrael Medical Association Journal
Volume12
Issue number3
StatePublished - Mar 2010
Externally publishedYes

Keywords

  • Heart failure
  • Inflammation
  • Interleukin-10
  • Prognosis
  • Tumor necrosis factor-alpha

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