title: Elevated circulating levels of thioredoxin and stress in chronic heart failure.
abstract: BACKGROUND
  Chronic heart failure (CHF) is a complex syndrome, in which reactive oxygen species and inflammatory cytokines are important stressors that contribute to the pathogenesis.
  
  
  OBJECTIVE
  We have studied physiological stress response parameters in CHF, in particular the redox-active regulator thioredoxin.
  
  
  METHODS
  A case-control study was conducted including a consecutive sample of CHF patients (n=27) of NYHA class II and III; comparison control subjects (n=29) were recruited from an association for retired people.
  
  
  METHODS
  Baseline levels of Trx, lipid peroxides (oxidative stress), TNF and IL-6 cytokines, platelet-activation marker P-selectin, cortisol (as peripheral effector of HPA axis), and the potent antioxidant selenoprotein Trx-reductase were assessed.
  
  
  RESULTS
  Mean (+/-S.E.M.) plasma levels of Trx were significantly higher in patients with CHF (32+/-3 ng/ml), than in the healthy subjects (12+/-3 ng/ml, P<0.0001). Trx levels increased in proportion to severity of disease (NYHA class III>NYHA class II) and degree of stress. Trx elevation correlated well with increased oxidative stress (lipid peroxides, P<0.0001), circulatory P-selectin (P<0.0001), morning level of free salivary cortisol (P=0.0002), and serum creatinine (P=0.0417), but not with pro-inflammatory cytokines TNF and IL-6.
  
  
  CONCLUSIONS
  Trx was strikingly elevated in heart failure cases compared with controls, signifying an adaptive stress response that is higher the more severe the disease.
authors.affiliation: Department of Biomedicine and Surgery, Division of Cell Biology, Linköping University, SE-581 85 Linköping, Sweden.
authors.forename: Andreas
authors.initials: A
authors.lastname: Jekell
authors.forename: Akter
authors.initials: A
authors.lastname: Hossain
authors.forename: Urban
authors.initials: U
authors.lastname: Alehagen
authors.forename: Ulf
authors.initials: U
authors.lastname: Dahlström
authors.forename: Anders
authors.initials: A
authors.lastname: Rosén
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D016022:Case-Control Studies; D002908:Chronic Disease; D003404:Creatinine / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D006333:Heart Failure / Q000378:metabolism*; D006801:Humans; D015850:Interleukin-6 / Q000378:metabolism; D008054:Lipid Peroxides / Q000097:blood; D008297:Male; D018384:Oxidative Stress; D019007:P-Selectin / Q000097:blood; D015539:Platelet Activation; D012720:Severity of Illness Index; D013312:Stress, Physiological / Q000378:metabolism*; D013548:Sweden; D013879:Thioredoxins / Q000097:blood*; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D008054:Lipid Peroxides; D019007:P-Selectin; D014409:Tumor Necrosis Factor-alpha; D013879:Thioredoxins; D003404:Creatinine