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European Journal of Heart Failure 2004 6(7):877-882; doi:10.1016/j.ejheart.2004.03.017
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© 2004 European Society of Cardiology

Soluble TNF-{alpha} and interleukin-6 receptors in the urine of heart failure patients. Their clinical value and relationship with plasma levels

Miguel Riveraa,*, Raquel Taléns-Viscontia, Rafael Sireraa, Vicente Bertomeub, Antonio Salvadorc, Raquel Cortésa, Fernando García de Burgosd, Vicente Climente, Rafael Payáf, Luis Martinez-Dolzg, Maria Jose Sancho-Tellog and Andrés González-Molinaa

a Research Center La Fe Hospital, José María Haro 59, Puerta 59, 46022 Valencia, Spain
b San Juan Hospital Alicante, Spain
c Dr. Peset Hospital Valencia, Spain
d Elche Hospital Elche, Spain
e General Hospital Alicante, Spain
f General Hospital Valencia, Spain
g La Fe Hospital Valencia, Spain

* Corresponding author. Tel.: +34-96-371-61-98; Fax: +34-96-1973018. E-mail address: rivera_jmi{at}gva.es


  Abstract

Background: Proinflammatory cytokines are important mediators in heart failure (HF). Recently, urinary levels of tumor necrosis factor-{alpha} (TNF-{alpha}) and interleukin-6 (IL-6) have been determined.

Aims: The purpose of this study was to measure the urinary levels of TNF-{alpha} and IL-6 receptors, sTNF-RI, sTNF-RII, sIL-6R, and the relationship with plasma levels and NYHA classes in HF.

Methods: Plasma and urine were collected from 114 HF patients and sTNF-RI, sTNF-RII and sIL-6R (ng/ml) were analyzed.

Results: For the whole population, plasma levels of sTNF-RI were 2.1±0.1, of sTNF-RII were 5.0±0.3 and of sIL-6R were 49.8±2.5. Urinary levels were: sTNF-RI, 2.8±0.5, r=0.5, p<0.001; sTNF-RII, 12.6±2.1, r=0.4, p<0.001; and sIL-6R, 4.2±0.4, NS. In NYHA III subjects, we found sTNF-RI, r=0.6, p<0.01, sTNF-RII, r=0.5, p<0.05, and sILR-6, r=0.5, p<0.05. Both plasma TNF receptors and urinary levels of sTNF-RII were higher in patients in a more severe NYHA class (p<0.05).

Conclusions: Urine is a good environment to study sTNF-RI and sTNF-RII, and this fact has diagnostic and prognostic implications. Plasma and urinary levels of TNF receptors showed a fair correlation, which was increased in higher NYHA classes. Plasma and urinary levels of sIL6R showed a good correlation in NYHA III. The TNF receptor levels in urine increased in patients with more severe HF.

Key Words: Cytokine receptors • Heart failure • Urine

Received November 26, 2003; Revised February 4, 2004; Accepted March 10, 2004


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