Tumor necrosis factor alpha (TNF alpha) is cardiodepressant in pathophysiologically relevant concentrations without inducing inducible nitric oxide-(NO)-synthase (iNOS) or triggering serious cytotoxicity
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Published on: July 20, 2019
U Müller-Werdan1, H Schumann, R Fuchs
1Department of Medicine III, Klinikum Kröllwitz, University of Halle-Wittenberg, Ernst-Grube-Strasse 40, Halle, D-06097, Germany.
Insights
Tumor necrosis factor alpha (TNF alpha) depresses heart cell contractility independently of nitric oxide (NO) in low, non-toxic concentrations. This finding challenges the established role of NO in TNF alpha-induced cardiac dysfunction, suggesting alternative mechanisms in heart failure.
Area of Science:
- Cardiology
- Molecular Biology
- Cell Biology
Background:
- Elevated tumor necrosis factor alpha (TNF alpha) is linked to cardiac hypertrophy and heart failure, but its role is debated.
- TNF alpha's negative inotropic effect in septic cardiomyopathy is often attributed to inducible nitric oxide synthase (iNOS) and nitric oxide (NO) production.
Purpose of the Study:
- To investigate whether TNF alpha affects cardiomyocyte contractility independently of NO production.
- To determine the concentration-dependent effects of TNF alpha on cardiomyocyte function and iNOS expression.
Main Methods:
- Primary neonatal rat cardiomyocytes were treated with varying concentrations of TNF alpha.
- Contractile performance was assessed by measuring beating amplitude and response to adrenergic stimulation.
- iNOS induction was evaluated using reverse transcriptase polymerase chain reaction (RT-PCR).
- Nitrite levels in cell culture supernatants were measured as an indicator of NO production.
Main Results:
- Low TNF alpha concentrations (10 U/ml) impaired adrenergic-stimulated contractility and calcium responsiveness without altering basal contractility.
- These low concentrations did not induce iNOS mRNA or increase nitrite production, even with dexamethasone.
- High TNF alpha concentrations (1000 U/ml) weakly induced iNOS mRNA and moderately increased nitrite production, accompanied by increased interleukin-6 release.
Conclusions:
- TNF alpha depresses cardiomyocyte contractility at pathophysiologically relevant concentrations independent of NO.
- The findings suggest that NO-independent mechanisms contribute to TNF alpha-induced cardiac dysfunction.
- This study provides novel insights into the non-inotropic effects of TNF alpha on the heart.
Abstract:
Cardiac hypertrophy and heart failure are frequently accompanied by elevated plasma levels of tumor necrosis factor alpha (TNF alpha), the pathogenetic relevance of this finding being a matter of debate. In human acute septic cardiomyopathy, on the other hand, the negative inotropic impact of TNF alpha on the heart is well documented and frequently ascribed to the induction of inducible nitric oxide (NO) synthase (iNOS) and an enhanced production of NO in the heart. Yet the present study presents evidence that in cardiomyocytes TNF alpha in non-toxic concentrations specifically depresses contractile performance independent of NO. In spontaneously beating neonatal rat cardiomyocytes, TNF alpha in a low, pathophysiologically relevant concentration (10 U/ml, 1-3 days) does not alter basal pulsation amplitude, but blocks alpha- and beta-adrenoceptor-stimulated increase in contractility and beating irregularity and impairs the impact of high extracellular calcium on contractile performance. However, this low TNF alpha-concentration does not suffice to induce iNOS - documented by reverse transcriptase polymerase chain reaction - or enhance nitrite concentrations in the cell culture supernatants as a measure of cellular NO production, neither in the presence nor absence of dexamethasone (0.1 micro M). Only in high concentration - the specific proinflammatory action being documented by an enhanced release of interleukin-6 from cardiomyocytes - TNF alpha (1000 U/mol; 6, 24 h) weakly induces the mRNA for iNOS, with a consecutive moderate rise in cellular nitrite production. TNF alpha-incubation (10-1000 U/ml) does not alter the morphological appearance of the cells displayed by phase contrast microscopy or evoke gross cytotoxicity.
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