Pericardial cytokines in neoplastic, autoreactive, and viral pericarditis

• Published in: Heart failure reviews Vol. 18; no. 3; pp. 345 - 353
• Main Authors: Ristić, Arsen D., Pankuweit, Sabine, Maksimović, Ružica, Moosdorf, Rainer, Maisch, Bernhard
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.05.2013; Springer Nature B.V
• Subjects: Adult; Age; Aged; Autoimmune Diseases - complications; Cardiology; Exudates and Transudates - metabolism; Female; Humans; Immunohistochemistry; Inflammation - metabolism; Interferon-gamma - analysis; Interferon-gamma - metabolism; Interleukin-6 - analysis; Interleukin-6 - metabolism; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasms - complications; Pericardial Effusion - diagnosis; Pericardial Effusion - etiology; Pericardial Effusion - metabolism; Pericardiocentesis - methods; Pericarditis - diagnosis; Pericarditis - etiology; Pericarditis - metabolism; Statistics as Topic; Transforming Growth Factor beta1 - analysis; Transforming Growth Factor beta1 - metabolism; Tumor Necrosis Factor-alpha - analysis; Tumor Necrosis Factor-alpha - metabolism; Virus Diseases - complications; Interleukin 6; Pericarditis; Transforming growth factor beta1; Tumor necrosis factor alpha; Cytokines; Interferon gamma
• ISSN: 1382-4147; 1573-7322; 1573-7322
• DOI: 10.1007/s10741-012-9334-y

Pericardial cytokine patterns in various diseases are not well established. We have analyzed pericardial proinflammatory (interleukin (IL)-6 and tumor necrosis factor (TNF)-alpha) and immunoregulatory cytokines (transforming growth factor (TGF)-beta1 and interferon (IFN)-gamma) in patients with pericarditis, myocarditis, and ischemic heart disease. Pericardial fluid was obtained in 30 subsequent patients undergoing pericardiocentesis (Group 1: 60 % males, 52.4 ± 14.2 years) and in 21 patients during aortocoronary bypass surgery (Group 2: 42.9 % males, age 67.2 ± 7.4 years). After clinical, laboratory, echocardiography examination, fiberoptic pericardioscopy (Storz-AF1101Bl, Germany) and pericardial/epicardial biopsy Group 1 was subdivided to 40 % neoplastic, 36.6 % autoreactive, 10 % iatrogenic, and 13.3 % viral pericarditis. Samples were promptly aliquoted, frozen, and stored at −70 °C. The cytokines were estimated using quantikine enzyme amplified-sensitivity immuno-assays (R&D Systems, USA) and the results compared between neoplastic, viral, iatrogenic, and autoreactive pericarditis and surgical groups. IL-6 was significantly increased in PE versus serum in all forms of pericarditis (except in autoreactive) and increased in comparison with pericardial fluid of surgical patients. TNF-alpha was increased only in PE of patients with viral pericarditis in comparison with Group 2. TGF-beta1 was strikingly lower in the PE than in the serum of all pericarditis patients. However, TGF-beta1 levels in PE were significantly higher in Group 1 than in Group 2, except in viral pericarditis. IFN-gamma levels did not significantly differ between PE and serum or in comparison with Group 2. The cytokine pattern “high TNF-alpha/low TGF-beta1” was found in viral pericarditis and low IL-6 in autoreactive PE. Different etiologies of pericardial inflammation did not influence the IFN-gamma levels. IL-6 pericardial to serum ratio was significantly higher in autoreactive PE than in viral and neoplastic forms. However, TNF-alpha and IFN-gamma pericardial to serum ratios were significantly higher in viral than in autoreactive and neoplastic PE.