© 1999 by European Society of Cardiology
Copyright © 1999, European Society of Cardiology
Tumour necrosis factor alpha and the cardiovascular system: its role in cardiac allograft rejection and heart disease
Department of Pathology, Regional Cardiothoracic Centre, Wythenshawe Hospital, Southmoore Road, Manchester M23 9LT, UK
* Corresponding author. Tel.: +44-161-282-1261; fax: +44-161-718-7167
Received 6 November 1998; accepted 29 March 1999
KEYWORDS Human; Rejection; Heart failure; Myocardium; Atherosclerosis
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1 Introduction |
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Tumour necrosis factor alpha (TNF
) is a pleiotropic cytokine that has many proinflammatory actions with negative inotropic effects. It has been implicated in the pathogenesis of many non-infectious disorders, from rheumatoid disease [1], to multiple sclerosis [2]. This cytokine also affects the heart [3] where it is produced by immune cells and the myocardium in some diseases. Raised serum TNF is seen in patients with cardiomyopathy, myocardial infarction, and chronic heart failure [4], thus implicating TNF in disease pathogenesis. Raised serum levels of this cytokine have also been identified in transplant patients following episodes of acute cellular rejection. There is a correlation between TNF expression and rejection grade [5] suggesting that the cytokine is a candidate marker of rejection.
In this review, we consider the basic biology of TNF in relation to certain cardiac diseases. There are interrelationships between some of the conditions described, but these
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2 Basic biology and function of TNF: a summary
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2.1 TNF
molecule2.2 Molecular regulation of TNF
production2.3 Genetic variation in TNF
levels2.4 Effects of TNF
on cardiac function |
3 Role of TNF in allograft rejection
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3.1 Allograft rejection: the need for a predictor
3.2 Involvement of TNF
in rejection3.3 Can TNF
be used as a predictor for rejection? |
4 Role of TNF in coronary artery disease (CAD)
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4.1 Coronary angioplasty
4.2 Cardiopulmonary bypass and coronary artery grafts
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5 Role of TNF in heart failure
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6 Conclusion |
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