CYTOKINE PROFILE OF Th1-, Th2- AND Th17-LYMPHOCYTE SUBPOPULATIONS IN INFECTIOUS MYOCARDITIS

Background: Type 17 T-helpers (Th17) were first identified more than 10 years ago. Though, there are only limited studies on the role of Th17- mediated mechanisms in the immune pathogenesis of acute myocarditis and dilative cardiomyopathy. Aim: To assess specific cytokine profile in patients with infectious immune myocarditis and post-myocarditis cardiosclerosis. Materials and methods: 35 patients with infectious immune myocarditis, 39 patients with post-myocarditis cardiosclerosis and 10 healthy volunteers (control group) were enrolled. 17 subjects with infectious immune myocarditis had manifest heart failure. Mean concentrations of Th1-, Th2- and Th17-derived cytokines were measured using solid-phase enzyme-linked immunosorbent assay panel manufactured by VectorBest ZAO (Russia). For statistical analysis, PASW Statistics software was used. Results: Compared to healthy controls, patients with infectious immune myocarditis had higher serum interferon-gamma (IF-γ) concentrations and more than 3-fold increase of serum interleukin (IL)-4. They also had almost 7-fold increase of IL-17A and Th17 effector cytokines – IL-8 and granulocyte-macrophage colony-stimulating factor (GM-CSF). Patients with infectious immune myocarditis and moderate or no symptoms of heart failure had significantly lower concentrations of IF-γ compared to patients with advanced heart failure. Cytokine concentrations peaked during the first 2 week of the disease, with following decrease. On the contrary, serum IL-4 grew significantly by the end of the first month and during the second month of the disease. Raised concentrations of IL-17A, IL-8 and GM-CSF were found throughout the period from the second week to the second month of the disease. Th17-derived cytokines concentrations were significantly increased in patients with post-myocarditis cardiosclerosis. Compared to the controls, IL-17A almost doubled, IL-8 increased by 51%, and GM-CSF – by 50%. Elevated concentrations of IL-4, IL-17A, IL-8 and GM-CSF were found in patients with duration of post-myocarditis cardiosclerosis less than 6 months. Conclusion: Disorders of anti-infective immunity and deficient self-limitation mechanisms of immune response play an important role in the development and progression of inflammatory myocardial diseases.