Increase of plasma IL-9 and decrease of plasma IL-5, IL-7, and IFN-γ in patients with chronic heart failure

Background: Several cytokines are associated with the development and/or progression of chronic heart failure (CHF). Our aim was to look more closely at the cytokine networks involved in CHF, and to assess whether disease etiology affects cytokine expression. The study population was comprised of a) 69 patients with stable CHF, New York Heart Association (NYHA) II/IV classes, secondary to ischaemic (ICM) and non ischaemic dilated (NIDCM) cardiomyopathy and b) 16 control subjects. We analyzed and compared the plasma levels of 27 pro-and antiinflammatory mediators, in the study population and assessed for any possible correlation with echocardiographic parameters and disease duration. Methods: 27 cytokines and growth factors were analyzed in the plasma of ICM-(n = 42) and NIDCM (n = 27) NYHA class II-IV patients vs age-and gender-matched controls (n = 16) by a beadbased multiplex immunoassay. Statistical analysis was performed by ANOVA followed by Tukey post-hoc test for multiple comparison. Results: Macrophage inflammatory protein (MIP)-1 beta, Vascular endothelial growth factor (VEGF), interleukin (IL)-9, Monocyte chemotactic protein (MCP)-1, and IL-8 plasma levels were increased in both ICM and NIDCM groups vs controls. In contrast, IL-7, IL-5, and Interferon (IFN)-gamma were decreased in both ICM and NIDCM groups as compared to controls. Plasma IL-6 and IL-1 beta were increased in ICM and decreased in NIDCM, vs controls, respectively. IL-9 levels inversely correlated, in ICM patients, with left ventricular ejection fraction (LVEF) while IL-5 plasma levels inversely correlated with disease duration, in NYHA III/IV ICM patients. This is the first time that both an increase of plasma IL-9, and a decrease of plasma IL-5, IL-7 and IFN-gamma have been reported in ICM as well as in NIDCM groups, vs controls. Interestingly, such cytokines are part of a network of genes whose expression levels change during chronic heart failure. The altered expression levels of MIP-1 beta, VEGF, MCP-1, IL-1 beta, IL-6, and IL-8, found in this study, are in keeping with previous reports. Conclusions: The increase of plasma IL-9, and the decrease of plasma IL-5, IL-7 and IFN-gamma in ICM as well as in NIDCM groups vs controls may contribute to get further insights into the inflammatory pathways involved in CHF.