Proinflammatory cytokines in heart disease

Proinflammatory cytokines affect nearly all tissues and organ systems, and the vasculature is no exception. Although a considerable amount of research has focused on the role of the two most prominent proinflammatory cytokine s, interleukin-1 (IL-1) and tumor necrosis factor (TNF), in the pathogenesi s of sepsis and septic shock, the role of these and other cytokines in the pathogenesis of atherosclerotic lesions of the coronary artery, the acute i schemic event associated with myocardial infarction, the progression of myo cardiopathies or the loss of myocardial function in congestive heart failur e is a relatively recent discovery. Moreover, there has also been significa nt investigation of the cardioprotective effects of cytokines. Most of the attention has focused on the acute coronary syndromes and the myocardial su ppression that takes place as a result of acute ischemia. The potential for anticytokine-based therapies in treating heart disease is great. Parentera l TNF-alpha neutralization and IL-1 receptor blockade are presently used to treat rheumatoid arthritis. Two orally effective agents, the IL-1 beta -co nverting enzyme inhibitor and the mitogen-activating protein kinase p38 inh ibitor, are currently being investigated in clinical trials. Copyright (C) 2001 S. Karger AG, Basel.