Background: CHF manifestations can be explained by the biologic effects of tumor necrosis factor-alpha (TNF-alpha). Interleukin-10 (IL-10) has potent deactivating properties and is considered a potent anti-inflammatory cytokine that inhibits TNF-alpha production. This study was designed to examine the role of IL-10 in patients with CHF and to test its correlation with pro-inflammatory markers.
Methodology: Fifty patients with CHF were studied. Patients were classified according to NYHA functional class into 29 (NYHA II), 11 (NYHA III) and 9 patients (NYHA IV). Serum samples for TNF-alpha, IL-10, soluble TNF receptors (sTNF-R1 and sTNF-R2), transforming growth factor-beta (TGF-beta) as well as high sensitivity C-reactive protein (hs-CRP) were taken from all patients and also from healthy, age and sex matched 50 controls.
Results: CHF patients had a significantly lower level of IL-10 compared to controls (2.28±1.1 vs 5.39±1.4 pg/ml, P<0.0001). Patients with NYHA class IV had the lowest serum levels of IL-10 and TGF-alpha which were statistically significant when compared to patients with NYHA class III (0.67±0.4 vs 1.9±0.5 pg/ml, P<0.001) and (1348±92 vs 1653±111 pg/ml, P<0.05) respectively, but they had the highest serum level of TNF-alpha, sTNF-R1, sTNF-R2 and hs-CRP when compared to the same group (8.6±1.9 vs 7.1±0.8 pg/ml, P< 0.01), (2380±141 vs 1831±185 pg/ml, P< 0.01), (3410±174 vs 2841±191 pg/ml, P<0.01) and (26.4±2.7 vs 14.4±3.9 mg/L, P<0.01) respectively.
Conclusion: Patients with CHF had a significant decrease in their serum level of IL-10 and increase in TNF-alpha, sTNF-R1, sTNF-R2 and hs-CRP when compared to normal subjects and these levels change significantly with advanced NYHA class.