The TNF-α system in heart failure and after heart transplantation; plasma protein levels, mRNA expression, soluble receptors and plasma buffer capacity

Background The two soluble tumour necrosis factor (TNF) receptors (sTNF-R1, sTNF-R2) can bind TNF-α, which is a cytokine with cardiodepressant properties. In heart failure and after heart transplantation, the TNF-α system is unbalanced, due to elevated levels of sTNF receptors. Aim To assess the activity of the TNF-α system in patients with heart failure and after heart transplantation. Methods We measured TNF-αmRNA expression of peripheral blood mononuclear cells, plasma levels of TNF-α and sTNF reverse transcriptase receptors, using polymerase chain reaction and ELISA and performed a TNF-α binding capacity analysis, quantitating the buffer capacity of patients’ plasma. Results In 11 patients with heart failure and in 15 cardiac allograft recipients, the TNF-α mRNA expression was comparable to controls. This level of mRNA was not accompanied by detectable TNF-αplasma levels. Significantly higher sTNF receptors levels were found in patients: (P