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Correlation between the cytokine profile and anticongestive medication in patients with chronic chagasic cardiopathy
Rodrigo Cunha de Sousa1, Diego Bernardo de Deus1, Thiago Álvares da Costa2
1Universidade Federal do Triângulo Mineiro, Departamento de Medicina Interna, Uberaba, MG, Brasil.
Insights
Anti-congestive medications commonly used for chronic chagasic cardiopathy (CCC) may alter the immune response. Specifically, ACE inhibitors were associated with lower interferon gamma (IFN-γ), while amiodarone and aldosterone antagonists increased tumor necrosis factor alpha (TNF-α).
Area of Science:
- Immunology
- Cardiology
- Pharmacology
Background:
- Chronic chagasic cardiopathy (CCC) is a progressive dilated cardiomyopathy driven by chronic inflammation.
- Pro-inflammatory cytokines like tumor necrosis factor alpha (TNF-α) and interferon gamma (IFN-γ), and anti-inflammatory cytokines such as interleukin-10 (IL-10) and IL-17, are key in CCC pathogenesis.
- Early anti-congestive therapy can modify disease progression and immune response patterns.
Purpose of the Study:
- To evaluate the profile of Th1 and Th17 cytokines, including IL-17, TNF-α, and IFN-γ, across different stages of CCC.
- To investigate the impact of anti-congestive medications on cytokine expression in CCC patients.
Main Methods:
- A cross-sectional study involving 40 patients with chronic Chagas disease, categorized by disease stage (undetermined, cardiac, digestive).
- Serum levels of IFN-γ, TNF-α, IL-10, and IL-17 were measured.
- Patients were grouped based on their use of specific anti-congestive medications, including angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, amiodarone, and aldosterone antagonists.
Main Results:
- Lower serum IFN-γ concentrations were observed in patients using angiotensin-converting enzyme inhibitors (p = 0.0182).
- Patients treated with amiodarone and aldosterone antagonists exhibited higher serum TNF-α concentrations (p = 0.0106 and p = 0.0187, respectively).
- Interleukin-10 (IL-10) and IL-17 levels did not significantly differ between patient groups.
Conclusions:
- The cytokine profile and disease progression in CCC are influenced by commonly prescribed anti-congestive medications.
- These findings highlight the potential immunomodulatory effects of standard CCC therapies.
Introduction:
Chronic chagasic cardiopathy (CCC) is essentially a dilated cardiomyopathy in which a subacute, but constant chronic inflammatory process causes progressive destruction of the heart tissue. The action of proinflammatory cytokines, such as tumor necrosis factor alpha (TNF-α), interferon gamma (IFN-γ), and anti-inflammatory cytokines, like interleukin IL-10 and IL-17, plays a fundamental role in the immunopathogenesis and evolution of disease. Early anti-congestive therapy, aimed at changing the morbidity and mortality rate, has been shown to reduce disease progression and to alter patients' immune response pattern.
Methods:
This cross-sectional study aimed to evaluate the profile of Th1 and Th17 cytokines and IL-17, TNF-α, and IFN-γ expressions in different stages of CCC. Forty patients affected by chronic Chagas disease were divided into different groups according to the stage of the pathology. In agreement with the Brazilian consensus on Chagas disease, patients were classified as presenting an undetermined form, a cardiac form and a digestive form. Serum IFN-γ, TNF-α, IL-10, and IL-17 were evaluated.
Results:
Lower serum IFN-γ concentrations were detected in patients receiving angiotensin-converting enzyme inhibitors (p = 0.0182), but not in those using angiotensin receptor blockers (p = 0.0783). Patients using amiodarone and aldosterone antagonist presented higher serum TNF-α concentrations (p = 0.0106 and 0.0187, respectively). IL-10 and IL-17 levels did not differ between the study groups (p = 0.7273 and p = 0.6697, respectively).
Conclusions:
These results suggest that the cytokine profile and disease progression are altered by anti-congestive medications commonly prescribed for CCC.
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