title: Soluble TNF-alpha and interleukin-6 receptors in the urine of heart failure patients. Their clinical value and relationship with plasma levels.
abstract: 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.
authors.affiliation: Research Center La Fe Hospital, José María Haro, 59 Puerta, 46022 Valencia, Spain. rivera_jmi@gva.es
authors.forename: Miguel
authors.initials: M
authors.lastname: Rivera
authors.forename: Raquel
authors.initials: R
authors.lastname: Taléns-Visconti
authors.forename: Rafael
authors.initials: R
authors.lastname: Sirera
authors.forename: Vicente
authors.initials: V
authors.lastname: Bertomeu
authors.forename: Antonio
authors.initials: A
authors.lastname: Salvador
authors.forename: Raquel
authors.initials: R
authors.lastname: Cortés
authors.forename: Fernando
authors.initials: F
authors.lastname: García de Burgos
authors.forename: Vicente
authors.initials: V
authors.lastname: Climent
authors.forename: Rafael
authors.initials: R
authors.lastname: Payá
authors.forename: Luis
authors.initials: L
authors.lastname: Martinez-Dolz
authors.forename: Maria Jose
authors.initials: MJ
authors.lastname: Sancho-Tello
authors.forename: Andrés
authors.initials: A
authors.lastname: González-Molina
mesh_terms: 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*
chemical_list: D015415:Biomarkers; D019947:Receptors, Interleukin-6; D014409:Tumor Necrosis Factor-alpha