title: Increased systemic and myocardial expression of neutrophil gelatinase-associated lipocalin in clinical and experimental heart failure.
abstract: OBJECTIVE
  Neutrophil gelatinase-associated lipocalin (NGAL or lipocalin-2) is a glycoprotein with bacteriostatic properties. Growing evidence suggests that NGAL may also be involved in cell survival, inflammation, and matrix degradation. We therefore aimed to investigate the role of NGAL in heart failure (HF).
  
  
  RESULTS
  Our main findings were (i) patients with acute post-myocardial infarction (MI) HF (n = 236) and chronic HF (n = 150) had elevated serum levels of NGAL (determined by enzyme immunoassay), significantly correlated with clinical and neurohormonal deterioration, (ii) in patients with HF following acute MI, elevated NGAL levels of at baseline were associated with adverse outcomes (median of 27 months follow-up), (iii) in a rat model of post-MI HF, NGAL/lipocalin-2 gene expression was increased in the non-ischaemic part of the left ventricle primarily located to cardiomyocytes, (iv) strong NGAL immunostaining was found in cardiomyocytes within the failing myocardium both in experimental and clinical HF, (v) interleukin-1beta and agonists for toll-like receptors 2 and 4, representing components of the innate immune system, were potent inducers of NGAL/lipocalin-2 in isolated neonatal cardiomyocytes.
  
  
  CONCLUSIONS
  Our demonstration of enhanced systemic and myocardial NGAL expression in clinical and experimental HF further support a role for innate immune responses in the pathogenesis of HF.
authors.affiliation: Research Institute for Internal Medicine, Rikshospitalet University Hospital, University of Oslo, Oslo, Norway. arne.yndestad@medisin.uio.no
authors.forename: Arne
authors.initials: A
authors.lastname: Yndestad
authors.forename: Linn
authors.initials: L
authors.lastname: Landrø
authors.forename: Thor
authors.initials: T
authors.lastname: Ueland
authors.forename: Christen P
authors.initials: CP
authors.lastname: Dahl
authors.forename: Trude H
authors.initials: TH
authors.lastname: Flo
authors.forename: Leif Erik
authors.initials: LE
authors.lastname: Vinge
authors.forename: Terje
authors.initials: T
authors.lastname: Espevik
authors.forename: Stig S
authors.initials: SS
authors.lastname: Frøland
authors.forename: Cathrine
authors.initials: C
authors.lastname: Husberg
authors.forename: Geir
authors.initials: G
authors.lastname: Christensen
authors.forename: Kenneth
authors.initials: K
authors.lastname: Dickstein
authors.forename: John
authors.initials: J
authors.lastname: Kjekshus
authors.forename: Erik
authors.initials: E
authors.lastname: Øie
authors.forename: Lars
authors.initials: L
authors.lastname: Gullestad
authors.forename: Pål
authors.initials: P
authors.lastname: Aukrust