title: Cytokines in chronic heart failure: possible interaction in the neurohormonal and the cytokine system at the cAMP level?
abstract: In recent years, the pathophysiological concept of chronic heart failure (CHF) has changed from an isolated hemodynamic view to a more complex concept involving neuroendocrine and inflammatory pathways. New therapeutic strategies, such as beta-blocker therapy, are based on these new concepts and provide clinical evidence for a clinical benefit in patients with CHF. The survival benefit of beta-blocker therapy in CHF has been related to neurohumoral regulation. Thus, evidence evolved showing that following beta-blocker therapy cytokine levels in CHF patients are altered. We have shown that the levels of soluble TNF receptor type 2 correlated well with cAMP in leukocytes. Data from clinical studies in adult and infant CHF patients have demonstrated that beta-blocker therapy is accompanied by altered cytokine, cytokine antagonist, and/or soluble cytokine receptor levels. These alterations may result from a dysregulated interaction of beta-adrenergic pathways and the cytokine system, and are possibly related to cAMP-dependent regulation of the release or shedding of these mediators.
authors.affiliation: Institut für Pharmakologie und Toxikologie der Technischen Universität München, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Werner
authors.forename: Harald
authors.initials: H
authors.lastname: Loppnow
authors.forename: Mathias
authors.initials: M
authors.lastname: Rauchhaus
authors.forename: Armin
authors.initials: A
authors.lastname: Wessel
authors.forename: Karl
authors.initials: K
authors.lastname: Werdan
authors.forename: Reiner
authors.initials: R
authors.lastname: Buchhorn
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000242:Cyclic AMP / Q000502:physiology*; D016207:Cytokines / Q000502:physiology*; D006333:Heart Failure / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D018377:Neurotransmitter Agents / Q000502:physiology
chemical_list: D000319:Adrenergic beta-Antagonists; D016207:Cytokines; D018377:Neurotransmitter Agents; D000242:Cyclic AMP