title: Intramyocardial synthesis of pro- and anti-inflammatory cytokines in infants with congenital cardiac defects.
abstract: OBJECTIVE
  We sought to test the hypothesis that cytokines would be expressed in the myocardium of infants with congenital cardiac defects and to identify the signaling pathways involved.
  
  
  BACKGROUND
  Mechanical stress upregulates pro-inflammatory cytokines in the myocardium.
  
  
  METHODS
  Fifteen infants with tetralogy of Fallot (TOF) (n = 7) or with ventricular septal defects (VSDs) (n = 8) were investigated. Concentrations of pro- and anti-inflammatory cytokines and of the inducible nitric oxide synthase (iNOS) were measured by enzyme-linked immunosorbent assay and/or Western blotting in the right ventricular myocardium taken during cardiac surgery. Activation of the nuclear factor-kappa-B (NF-kappa-B) and p38 mitogen-activated protein kinase (MAPK) pathways was assessed by electrophoretic mobility shift assay with supershift and/or Western blotting, respectively.
  
  
  RESULTS
  The pro-inflammatory cytokines tumor necrosis factor (TNF)-alpha, interleukin (IL)-1-beta, and IL-6 and the anti-inflammatory cytokine IL-10 were detected in the myocardium of all patients. Concentrations of the pro-inflammatory cytokines and also of phosphorylated p38 MAPK were higher in patients with TOF than in those with VSD and correlated with the degree of pressure overload of the right ventricle. Levels of phosphorylated I-kappa-B-alpha, iNOS, and IL-10 were similar in patients with TOF and in those with VSD.
  
  
  CONCLUSIONS
  Our results show intramyocardial synthesis of pro-inflammatory cytokines in infants with congenital cardiac defects. This is associated with activation of both the NF-kappa-B and p38 MAPK pathways. The latter could be particularly important for the transduction of mechanical signals in the infant's myocardium. Synthesis of IL-10 indicates an intramyocardial anti-inflammatory potential in this age group.
authors.affiliation: Department of Pediatric Cardiology and Congenital Heart Diseases, German Heart Center Munich, Technical University Munich, Munich, Germany. ma@dhm.mhn.de
authors.forename: Ma
authors.initials: M
authors.lastname: Qing
authors.forename: Kathrin
authors.initials: K
authors.lastname: Schumacher
authors.forename: Ruth
authors.initials: R
authors.lastname: Heise
authors.forename: Michael
authors.initials: M
authors.lastname: Wöltje
authors.forename: Jaime F
authors.initials: JF
authors.lastname: Vazquez-Jimenez
authors.forename: Thomas
authors.initials: T
authors.lastname: Richter
authors.forename: Monika
authors.initials: M
authors.lastname: Arranda-Carrero
authors.forename: John
authors.initials: J
authors.lastname: Hess
authors.forename: Götz
authors.initials: G
authors.lastname: von Bernuth
authors.forename: Marie Christine
authors.initials: MC
authors.lastname: Seghaye
mesh_terms: D016207:Cytokines / Q000032:analysis* / Q000096:biosynthesis*; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D006352:Heart Ventricles / Q000378:metabolism / Q000601:surgery; D006801:Humans; D007223:Infant; D007249:Inflammation / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D007375:Interleukin-1 / Q000032:analysis / Q000096:biosynthesis; D016753:Interleukin-10 / Q000032:analysis / Q000096:biosynthesis; D015850:Interleukin-6 / Q000032:analysis / Q000096:biosynthesis; D008297:Male; D009206:Myocardium / Q000378:metabolism* / Q000473:pathology; D019001:Nitric Oxide Synthase / Q000032:analysis / Q000096:biosynthesis; D052247:Nitric Oxide Synthase Type II; D015398:Signal Transduction / Q000502:physiology*; D013771:Tetralogy of Fallot / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis / Q000096:biosynthesis; D015854:Up-Regulation / Q000502:physiology*
chemical_list: D016207:Cytokines; D007375:Interleukin-1; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; C496319:NOS2 protein, human; D019001:Nitric Oxide Synthase; D052247:Nitric Oxide Synthase Type II