Bidzilya P.

CONTENT OF CYTOKINES IN CHRONIC HEART FAILURE PATIENTS WITH OVERWEIGHT AND OBESITY

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About the author:	Bidzilya P.
Heading	CLINICAL MEDICINE
Type of article	Scentific article
Annotation	The last decade, interest of scientists aims to study the potential role of inflammatory mediator’s cytokines in the pathogenesis of chronic heart failure (CHF). Cytokines are divided into proinflammatory (interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and anti-inflammatory (interleukin-10 (IL-10), etc.). In conditions of normal homeostasis, the balance is maintained in their relationships. The imbalance hyperactivation link triggers a cascade of systemic and local inflammatory reactions, which contribute to the development and progression of CHF. In addition to direct involvement in the regulation of inflammatory responses, cytokines are involved in the platelet aggregation, coagulation hemostasis, lipid metabolism, induce progression of myocardial hypertrophy and remodeling in parallel with apoptotic processes, contributing to the development of systolic and diastolic dysfunction of the left ventricle. In patients with CHF is hyperactivation of the immune inflammation, which is manifested by increased blood levels of proinflammatory IL-6 and TNF-α. The degrees of elevation of IL-6 and TNF-α in CHF have a direct correlation with disease severity. High levels of proinflammatory cytokines associated with the worst survival rate and great mortality in patients with CHF regardless of the etiology of the disease. On the other hand is an ongoing debate regarding activity in terms of CHF anti-inflammatory cytokines. Some authors found a low concentration of IL-10 in CHF, however, more recent data indicate a high level. There is a direct dependence of the level of IL-10 with disease progression, worse prognosis and high mortality in CHF. Recently considerable success has been achieved in the treatment of CHF that were based on hemodynamics and neurohumoral theory of the development of the disease. However, the morbidity and mortality of CHF patients remains high, which is probably due to the involvement of the pathogenetic process of disease other units, namely the formation of inflammatory changes. Today continues global spread in the population of overweight obesity, which is one of the main predictors of CHF. However, the debate continues relative pathological or protective role of obesity (the "obesity paradox") for, and consequences of existing CHF. It is known that adipose tissue is a potent hormonally active system that produces a large number of biologically active substances, adipocytokines, in particular the proinflammatory cytokines IL-6 and TNF-α. Thus, considering the above and the insufficient number of works that have studied the status of the inflammatory changes in CHF patients with concomitant overweight and obesity, the chosen direction of research is timely and relevant. Research objective: To explore content of IL-6, IL-10 and TNF-α in the blood serum in CHF on the background of overweight and obesity. Material and methods: A total of 105 patients of the main group who had CHF of II–III functional class (FC) with normal, overweight and obesity of I–III stages. CHF was caused by chronic forms of ischemic heart disease (stable angina, post infarction and diffuse cardiosclerosis), arterial hypertension and their combination. The comparison group comprised 12 patients with normal weight without clinical and instrumental signs of CHF, compatible for age and gender factor. By calculating the body mass index (BMI) normal, overweight and degree of obesity were determined. By ELISA method the in blood serum was measured level of IL-6, IL-10 and TNF-α. Results: It is established that in CHF with overweight and obesity the immune-inflammatory changes characterized with increase of content of proinflammatory IL-6 and TNF-α and anti-inflammatory IL-10, which have a direct correlation with the CHF FC and age. The level of IL-6 and IL-10 directly correlated with BMI. Conclusions In CHF patients with overweight and obesity immune-inflammatory changes represented by increase in serum concentration of IL-6, IL-10, TNF-α, which directly depend on the severity of the disease and age, and IL-10 are rising with increasing BMI.
Tags	Chronic Heart Failure, IL-6, IL-10, TNF-α, Overweight, Obesity
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Publication of the article	«World of Medicine and Biology» №2(60), 2017 year, 012-017 pages, index UDK 616.12-008.46-039-06: 616-056.52]-097