title: Elevated concentrations of CCL2 and tumor necrosis factor-alpha in chagasic cardiomyopathy.
abstract: Chronic myocarditis is the main pathological finding associated with Chagas disease-related morbidity. Concentrations of CCL2, CCL3, tumor necrosis factor (TNF)-alpha, and brain natriuretic peptide (BNP) were evaluated in plasma samples obtained from patients with different clinical forms of chronic chagasic cardiomyopathy. Patients with more-severe Chagas disease had elevated plasma concentrations of TNF-alpha, CCL2, and BNP, and there was a good correlation between levels of these proteins (especially TNF-alpha ) and the degree of heart dysfunction. Indeed, TNF-alpha level was an excellent predictor of heart failure. Peripheral blood mononuclear cell samples obtained from patients with mild or severe chagasic cardiomyopathy produced greater amounts of TNF-alpha and CCL2 than did those obtained from noninfected individuals. The elevation of TNF-alpha and CCL2 levels in the plasma of patients appears to be secondary to the degree of heart dysfunction, whereas spontaneous production of TNF-alpha and CCL2 by mononuclear cells is secondary not only to heart dysfunction, but also to the underlying inflammation in the heart of chagasic patients. Measurement of the TNF-alpha level could be a useful tool in the identification of patients with heart dysfunction who may benefit from further investigation and treatment.
authors.affiliation: Departamento de Bioquimica e Imunologia, Instituto de Ciencias Biologicas, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte Mg Brasil.
authors.forename: André
authors.initials: A
authors.lastname: Talvani
authors.forename: Manoel O C
authors.initials: MO
authors.lastname: Rocha
authors.forename: Lucíola S
authors.initials: LS
authors.lastname: Barcelos
authors.forename: Yara M
authors.initials: YM
authors.lastname: Gomes
authors.forename: Antônio L
authors.initials: AL
authors.lastname: Ribeiro
authors.forename: Mauro M
authors.initials: MM
authors.lastname: Teixeira
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis; D002598:Chagas Cardiomyopathy / Q000097:blood* / Q000378:metabolism; D018932:Chemokine CCL2 / Q000097:blood*; D054405:Chemokine CCL3; D054407:Chemokine CCL4; D006801:Humans; D019402:Macrophage Inflammatory Proteins / Q000097:blood; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000378:metabolism; D011379:Prognosis; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D018932:Chemokine CCL2; D054405:Chemokine CCL3; D054407:Chemokine CCL4; D019402:Macrophage Inflammatory Proteins; D014409:Tumor Necrosis Factor-alpha; D020097:Natriuretic Peptide, Brain