title: Interleukin-6 and tumor necrosis factor-α are associated with quality of life-related symptoms in pulmonary arterial hypertension.
abstract: BACKGROUND
  Inflammation is associated with symptoms in many chronic illnesses; however, this link has not been established in pulmonary arterial hypertension.
  
  
  OBJECTIVE
  The objective of this study was to investigate the association between inflammatory markers and quality of life-related symptoms in patients with pulmonary arterial hypertension. We hypothesized that higher circulating IL-6 and tumor necrosis factor-α levels would be associated with worse quality of life-related symptoms.
  
  
  METHODS
  We performed a secondary analysis using baseline and 3-month assessments of 62 subjects in a clinical trial of aspirin and simvastatin to determine the association between plasma IL-6 and tumor necrosis factor-α levels and the Medical Outcomes Study Short Form-36 subscales (pain, vitality, mental health).
  
  
  RESULTS
  The mean age was 49.7±13.4 years; 87% were female. Higher IL-6 levels were significantly associated with lower Medical Outcomes Study Short Form-36 subscale scores, indicating worse bodily pain, vitality, and mental health (all P<0.01). Higher tumor necrosis factor-α levels were significantly associated with increased bodily pain, but better mental health scores.
  
  
  CONCLUSIONS
  IL-6 and tumor necrosis factor-α levels are associated with certain quality of life domains in patients with pulmonary arterial hypertension. Clinical trial registered with www.clinicaltrials.gov (NCT00384865).
authors.affiliation: 1 University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania.
authors.forename: Lea Ann
authors.initials: LA
authors.lastname: Matura
authors.forename: Corey E
authors.initials: CE
authors.lastname: Ventetuolo
authors.forename: Harold I
authors.initials: HI
authors.lastname: Palevsky
authors.forename: David J
authors.initials: DJ
authors.lastname: Lederer
authors.forename: Evelyn M
authors.initials: EM
authors.lastname: Horn
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Mathai
authors.forename: Diane
authors.initials: D
authors.lastname: Pinder
authors.forename: Christine
authors.initials: C
authors.lastname: Archer-Chicko
authors.forename: Emilia
authors.initials: E
authors.lastname: Bagiella
authors.forename: Kari E
authors.initials: KE
authors.lastname: Roberts
authors.forename: Russell P
authors.initials: RP
authors.lastname: Tracy
authors.forename: Paul M
authors.initials: PM
authors.lastname: Hassoun
authors.forename: Reda E
authors.initials: RE
authors.lastname: Girgis
authors.forename: Steven M
authors.initials: SM
authors.lastname: Kawut
mesh_terms: D000284:Administration, Oral; D001241:Aspirin / Q000008:administration & dosage*; D015415:Biomarkers / Q000097:blood; D002908:Chronic Disease; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage; D006976:Hypertension, Pulmonary / Q000097:blood* / Q000188:drug therapy / Q000503:physiopathology; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D011446:Prospective Studies; D011669:Pulmonary Wedge Pressure / Q000187:drug effects; D011788:Quality of Life; D019821:Simvastatin / Q000008:administration & dosage*; D013997:Time Factors; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D015415:Biomarkers; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; C508600:IL6 protein, human; D015850:Interleukin-6; D010975:Platelet Aggregation Inhibitors; C439524:TNF protein, human; D014409:Tumor Necrosis Factor-alpha; D019821:Simvastatin; D001241:Aspirin
keywords: fatigue; interleukin-6; pain; pulmonary arterial hypertension; tumor necrosis factor-α