972–101 Cytokine Antagonists Increase in the Circulation During Myocardial Ischemia and Reperfusion

In the present research, we tested the idea that cytokine antagonists are released during acute myocardial ischemia and reperfusion to counteract pro-inflammatory effects of cytokines. We investigated changes in plasma concentrations of the anti-cytokine molecules α-melanocyte stimulating hormone (α-MSH), interleukin-1 receptor antagonist (IL-1 ra), and soluble tumor necrosis factor receptor (s TNF r) in patients with acute myocardial infarction (AMI) or unstable angina (UA) treated with thrombolytic agents compared to patients who did not receive thrombolysis, The study includes 32 pts presenting with prolonged chest pain and ST-segment changes on ECG; the final diagnosis was AMI in 24 and UA in 8 patients; 26 pts received thrombolytic therapy, There was no difference in the duration of chest pain at presentation between the thrombolysis and no thrombolysis groups, Blood samples were collected at admission in the CU and at 3h intervals for 24h, Comparisons of plasma α-MSH concentrations in thrombolysis and untreated groups showed highly significant differences: whereas concentrations of the peptide were elevated in early samples of patients treated with a thrombolytic agent, they were consistently low in untreated subjects, IL-l ra levels were likewise greater 3 and 6h post treatment in patients who underwent thrombolysis, whereas there was no significant difference for plasma s TN Fr between the two groups. We suggest that during myocardial ischemia and reperfusion anti-cytokine molecules released within the injured myocardium reduce inflammation caused by cytokines and other mediators of inflammation