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Determination of the Th1, Th2, Th17, and Treg cytokine profile in patients with chronic Chagas heart disease and systemic arterial hypertension

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Abstract

Chronic Chagas heart disease (CCHD affects about 30% of patients with chronic Chagas disease (CCD). Systemic arterial hypertension (SAH) afflicts about 25% of patients with CCD. The association of CCHD with SAH (CCHD–SAH) predisposes patients to develop chronic heart failure. The role of cytokines in disease progression in patients with CCHD–SAH is unknown. Accordingly, the aim of this study was to evaluate the plasma levels of cytokines expressing the Th1, Th2, Th17 pattern, as well as Treg cytokines, TNF-alpha, IL-1β, IL-8, IL-7 in patients with SAH-CCHD to get insight into the immunomodulation process in patients with this condition. Fifteen patients with CCHD, 22 patients with CCHD–SAH, and 28 controls were studied. All patients underwent history-taking, physical examination, 12-lead resting ECG, chest X-ray, and Doppler-echocardiogram. Ten of 15 (66%) patients with CCHD, and 16 of 22 (73%) patients with CCHD–SAH had decreased left ventricular ejection fraction (p > 0.05). Cytokines levels were performed on plasma samples using the ELISA method. Overall, proinflammatory, anti-inflammatory, and regulatory cytokine levels were increased in patients with CCHD–SAH in comparison to patients with CCHD and controls. However, such a difference was higher regarding IL-2, IL-5, IL-17, IL-12, and TNF-alpha cytokine levels, respectively. Cytokine levels were higher in CCHD patients in comparison to controls. Patients with CCHD–SAH have increased plasma levels of pro-inflammatory, anti-inflammatory, and regulatory cytokines in comparison with CCHD patients, thus suggesting a higher level of immunomodulation in patients with CCHD–SAH.

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Acknowledgements

Funding was provided by Universidade de Ribeirão Preto.

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  1. Reinaldo B. Bestetti and Renata Dellalibera-Joviliano takes the responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation. Equal contribution of first authors.

Authors and Affiliations

  1. Department of Medicine, UNAERP Medical School, University of Ribeirão Preto, Avenida Costábile Romano 2201, Ribeirão Prêto, 14096-900, Brazil

    Reinaldo B. Bestetti, Renata Dellalibera-Joviliano, Gabriel S. Lopes, Milton Faria-Jr, Rosemary Furlan-Daniel & Divino R. Batista

  2. São Rafael Clinic, Piumhi, Brazil

    Kenio C. Lopes

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  1. Reinaldo B. Bestetti
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Bestetti, R.B., Dellalibera-Joviliano, R., Lopes, G.S. et al. Determination of the Th1, Th2, Th17, and Treg cytokine profile in patients with chronic Chagas heart disease and systemic arterial hypertension. Heart Vessels 34, 123–133 (2019). https://doi.org/10.1007/s00380-018-1228-z

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