プラズマサイトカインのパラメータと慢性心不全患者の死亡率

M Rauchhaus¹, W Doehner, D P Francis

¹Clinical Cardiology, National Heart and Lung Institute, Royal Brompton Hospital, London, UK. mathias.rauchhaus@medizin.uni-halle.de

Circulation

|January 11, 2000

まとめ

溶解性腫瘍死滅因子受容体1 (sTNF-R1) は,慢性心不全 (CHF) の死亡率の強い予測因子である. より高いsTNF-R1レベルは,CHF患者の死亡リスクが高いことを示します.

科学分野:

心臓病学心臓病学
免疫学免疫学とは
バイオマーカーの研究

背景:

炎症性免疫活性化は,慢性心不全 (CHF) の重要な特徴です.
腫瘍死滅因子アルファ (TNF-alpha),溶解性TNF受容体 (sTNF-R1/sTNF-R2),インタールイキン-6 (IL-6) および溶解性CD14 (sCD14) のような特定の炎症マーカーの予後的意義は,CHF患者において不明のままである.

研究の目的:

慢性心不全患者のTNF-α,sTNF-R1,sTNF-R2,IL-6,sCD14の予後的重要性を調査する.
CHFにおける死亡率を予測するための最も正確な炎症バイオマーカーを特定する.

主な方法:

152人のCHF患者における免疫変数の血濃度の見通し評価.
死亡事件を記録するために,平均34ヶ月の追跡調査を行った.
予後精度を評価するために,受信機動作特性 (ROC) 分析を含む単変数および多変数分析を行います.

主要な成果:

TNF-alpha,sTNF-R1,sTNF-R2,sCD14,およびIL-6の濃度の上昇は,単変量分析では24カ月後の死亡率の増加と関連していた.
溶性TNF受容体1 (sTNF-R1) は,評価されたすべてのサイトカインパラメータの中で,最も強く,最も正確な予後指標として浮上しました.
sTNF-R1の予後値は,確立されたCHFの重症度マーカーとフォローアップの持続時間とは無関係でした.

結論:

sTNF-R1は,慢性心不全患者の死亡率の非常に正確で独立した予後マーカーです.
sTNF-R1の測定は,高リスクのCHF患者を特定し,抗TNF-α治療のモニタリングに役立ちます.

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