Soluble TNF-alpha and interleukin-6 receptors in the urine of heart failure patients. Their clinical value and relationship with plasma levels.
BACKGROUND
Proinflammatory cytokines are important mediators in heart failure (HF). Recently, urinary levels of tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) have been determined.


OBJECTIVE
The purpose of this study was to measure the urinary levels of TNF-alpha and IL-6 receptors, sTNF-RI, sTNF-RII, sIL-6R, and the relationship with plasma levels and NYHA classes in HF.


METHODS
Plasma and urine were collected from 114 HF patients and sTNF-RI, sTNF-RII and sIL-6R (ng/ml) were analyzed.


RESULTS
For the whole population, plasma levels of sTNF-RI were 2.1+/-0.1, of sTNF-RII were 5.0+/-0.3 and of sIL-6R were 49.8+/-2.5. Urinary levels were: sTNF-RI, 2.8+/-0.5, r=0.5, p<0.001; sTNF-RII, 12.6+/-2.1, r=0.4, p<0.001; and sIL-6R, 4.2+/-0.4, NS. In NYHA III subjects, we found sTNF-RI, r=0.6, p<0.01, sTNF-RII, r=0.5, p<0.05, and sILR-6, r=0.5, p<0.05. Both plasma TNF receptors and urinary levels of sTNF-RII were higher in patients in a more severe NYHA class (p<0.05).


CONCLUSIONS
Urine is a good environment to study sTNF-RI and sTNF-RII, and this fact has diagnostic and prognostic implications. Plasma and urinary levels of TNF receptors showed a fair correlation, which was increased in higher NYHA classes. Plasma and urinary levels of sIL6R showed a good correlation in NYHA III. The TNF receptor levels in urine increased in patients with more severe HF.
Rivera
Miguel
M
Research Center La Fe Hospital, José María Haro, 59 Puerta, 46022 Valencia, Spain. rivera_jmi@gva.es
Taléns-Visconti
Raquel
R
Sirera
Rafael
R
Bertomeu
Vicente
V
Salvador
Antonio
A
Cortés
Raquel
R
García de Burgos
Fernando
F
Climent
Vicente
V
Payá
Rafael
R
Martinez-Dolz
Luis
L
Sancho-Tello
Maria Jose
MJ
González-Molina
Andrés
A
D000368:Aged; D015415:Biomarkers / Q000097:blood / Q000652:urine; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000652:urine*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019947:Receptors, Interleukin-6 / Q000378:metabolism*; D012107:Research Design; D012720:Severity of Illness Index; D012995:Solubility; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*
D015415:Biomarkers; D019947:Receptors, Interleukin-6; D014409:Tumor Necrosis Factor-alpha