Plasma concentrations of inflammatory cytokines (IL-1 alpha, IL-1 beta
, IL-6, IL-8 and TNF alpha) were determined by ELISA in 27 patients wi
th acute rheumatic fever (RF), 12 with only arthritis (RFA) and 15 wit
h rheumatic heart disease (RHD), before, during and after treatment. A
ltogether, significant increases in TNF alpha, IL-8 and IL-6 levels we
re observed in the acute phase as compared to the data found during an
d after treatment. No significant differences were observed for the ot
her cytokines. Elevations of one or more of the inflammatory cytokines
were observed in 9 of 12 patients with RFA, and 12 of 15 with RHD. In
crease of TNF alpha (6/9) and IL-8 (5/9) levels were higher in RHD pat
ients with cardiac failure. These cytokines were below the detection l
imits on day 7 of treatment in all 22 patients, except in two, and in
all 10 days after treatment. Conclusions These findings suggest that i
nflammatory cytokines, as TNF alpha, IL-8 and IL-6, may play a pathoge
nic role in rheumatic fever.