© 2004 European Society of Cardiology
Elevated circulating levels of thioredoxin and stress in chronic heart failure
a Department of Biomedicine and Surgery, Division of Cell Biology, Linköping University SE-581 85 Linköping, Sweden
b Department of Medicine and Care, Division of Cardiology, Linköping University Linköping, Sweden
* Corresponding author. Tel.: +46-13-22-2794; Fax: +46-13-22-4314 E-mail address: Anders.Rosen{at}ibk.liu.se
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Abstract |
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Background: Chronic heart failure (CHF) is a complex syndrome, in which reactive oxygen species and inflammatory cytokines are important stressors that contribute to the pathogenesis.
Aim: We have studied physiological stress response parameters in CHF, in particular the redox-active regulator thioredoxin.
Subject: A case–control study was conducted including a consecutive sample of CHF patients (n=27) of NYHA class II and III; comparison control subjects (n=29) were recruited from an association for retired people.
Method: Baseline levels of Trx, lipid peroxides (oxidative stress), TNF and IL-6 cytokines, platelet-activation marker P-selectin, cortisol (as peripheral effector of HPA axis), and the potent antioxidant selenoprotein Trx-reductase were assessed.
Results: Mean (±S.E.M.) plasma levels of Trx were significantly higher in patients with CHF (32±3 ng/ml), than in the healthy subjects (12±3 ng/ml, P<0.0001). Trx levels increased in proportion to severity of disease (NYHA class III>NYHA class II) and degree of stress. Trx elevation correlated well with increased oxidative stress (lipid peroxides, P<0.0001), circulatory P-selectin (P<0.0001), morning level of free salivary cortisol (P=0.0002), and serum creatinine (P=0.0417), but not with pro-inflammatory cytokines TNF and IL-6.
Conclusion: Trx was strikingly elevated in heart failure cases compared with controls, signifying an adaptive stress response that is higher the more severe the disease.
Key Words: Thioredoxin • Oxidative stress • TNF • IL-6 • Inflammation • Chronic heart failure
Received August 22, 2003; Revised December 5, 2003; Accepted March 3, 2004
1 A J and A H contributed equally to the study.
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