Serial changes in plasma levels of cytokines in patients with coronary artery disease

Roberto H Heinisch1, Carlos R Zanetti1, Fabiano Comin1, Juliano L Fernandes2, José A Ramires2, Carlos V Serrano Jr21Federal University of Santa Catarina, Florianópolis, Brazil; 2Heart Institute (InCor), University of São Paulo Medical School, São Paulo, BrazilObjectives: Inflammation is known to be a major determinant of the progression of coronary artery disease (CAD). In the present study we have evaluated the plasma levels of cytokines – tumor necrosis factor-α (TNF), interleukin-1α (IL-1), interleukin-6 (IL-6), interferon-γ (IFN), and interleukin-10 (IL-10) – to examine the association between these cytokines and C-reactive protein (CRP) in patients with CAD.Methods: Patients with acute coronary syndromes (ACS; n = 20) were compared with patients with stable angina (SA; n = 20) and with control volunteers (C; n = 20). Blood samples were collected at the time of admission from all patients and 15 and 30 days thereafter.Results: CRP levels (20.8 ± 8.8 mg/L) (mean ± SEM) were higher at baseline in ACS than SA patients (4.1 ± 0.8 mg/L) or the control subjects (5.1 ± 1.8 mg/L) (p < 0.05). At admission, IL-6 was detected in 50% of the ACS patients and 5% of the SA patients or control subjects, while TNF was detected in 35% of the ACS and SA patients but only in 5% of control subjects. Subsequently, IL-6 levels declined and were no longer detectable, while TNF levels increased among ACS patients at all time periods tested when compared with other patients. The presence of IL-1 and IL-10 were not detectable in the blood samples examined, and IFN could only be detected in the ACS group. A significant correlation was observed between IL-6 and CRP levels (r = 0.4; p < 0.01) in all groups. There were no correlations among any of the other cytokines and CRP levels.Conclusions: Our study demonstrates raised levels of TNF, IL6, IFN, and CRP in patients with ACS and a positive correlation between IL6 and CRP but not with the other cytokines. Keywords: cytokines, tumor necrosis factor-α, interleukin-6, C-reactive protein, coronary artery diseas