Intramyocardial synthesis of pro- and anti-inflammatory cytokines in infants with congenital cardiac defects.
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.
Qing
Ma
M
Department of Pediatric Cardiology and Congenital Heart Diseases, German Heart Center Munich, Technical University Munich, Munich, Germany. ma@dhm.mhn.de
Schumacher
Kathrin
K
Heise
Ruth
R
Wöltje
Michael
M
Vazquez-Jimenez
Jaime F
JF
Richter
Thomas
T
Arranda-Carrero
Monika
M
Hess
John
J
von Bernuth
Götz
G
Seghaye
Marie Christine
MC
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*
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