[Immunactivation in chronic heart failure. Inflammatory mediators].
Inflammatory cytokines are thought to contribute to the development and progression of chronic heart failure (CHF). It has been shown that especially tumor necrosis factor-alpha (TNF) is activated in patients with CHF and exerts detrimental effects on the myocardium. Recent studies have demonstrated that circulating levels of TNF, soluble TNF receptors 1 and 2 and interleukin-6 are strong prognostic markers. The results of two randomized studies directly antagonizing TNF in CHF patients were rather disappointing. Nevertheless, TNF antagonism remains a therapeutic option and should be focussed on patients with systemic immune activation, particularly at times of exacerbation.
Genth-Zotz
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II. Medizinische Klinik und Poliklinik, Johannes-Gutenberg-Universität Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany. genth@2-med.klinik.uni-mainz.de
von Haehling
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Blankenberg
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D000276:Adjuvants, Immunologic / Q000378:metabolism*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D016207:Cytokines / Q000037:antagonists & inhibitors* / Q000276:immunology*; D000068800:Etanercept; D006321:Heart / Q000187:drug effects; D006333:Heart Failure / Q000188:drug therapy* / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage; D018836:Inflammation Mediators / Q000008:administration & dosage*; D000069285:Infliximab; D009206:Myocardium / Q000276:immunology*; D018124:Receptors, Tumor Necrosis Factor / Q000008:administration & dosage; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors / Q000276:immunology
D000276:Adjuvants, Immunologic; D000911:Antibodies, Monoclonal; D016207:Cytokines; D007074:Immunoglobulin G; D018836:Inflammation Mediators; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068800:Etanercept