Do Cytokines Play a Role in Predicting Some Features and Outcome in Infective Endocarditis?

Abstract

Objective: This study aimed to measure the serum concentrations of several cytokines in patients with infective endocarditis (IE), and correlate them with the C-reactive protein serum levels, echocardiographic findings and infecting microorganisms. Methods: Forty-five patients with definite IE according to the Duke’s criteria were included in the study. Ten healthy blood donors formed the control group. Serum levels of interleukin (IL) 1β, IL-6, IL-8, IL-10, IL-12 and tumor necrosis factor-α (TNF-α) were measured and compared between the groups, and also with some clinical and laboratory parameters of IE. Results: Patients with IE had significantly higher serum concentrations of the inflammatory mediators than the control patients. Median IL-12 and IL-1β levels were higher in staphylococcal than streptococcal IE. Except for TNF-α, the levels of all the other cytokines correlated with the C-reactive protein concentrations. In multivariate analysis, IL-10 and IL-12 serum levels remained as independent factors associated with the C-reactive protein concentrations. There was a significant correlation between IL-10 concentration and vegetation length. Conclusion: The inflammatory serum cytokines levels were elevated in IE in comparison to healthy controls. C-reactive protein concentrations correlated with cytokines levels. IL-1β and IL-12 serum concentrations were higher in staphylococcal when compared to streptococcal IE. IL-10 levels were associated with vegetation size.

Share and Cite:

M. Nunes, I. Araújo, A. Carvalho, L. Andrade, M. Resende, J. Silva and T. Ferrari, "Do Cytokines Play a Role in Predicting Some Features and Outcome in Infective Endocarditis?," Advances in Infectious Diseases, Vol. 3 No. 2, 2013, pp. 115-119. doi: 10.4236/aid.2013.32018.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] V. H. Chu, C. H. Cabell, D. K. Benjamin Jr., E. F. Kuniholm, V. G. Fowler Jr., J. Engemann, D. J. Sexton, G. R. Corey and A. Wang, “Early Predictors of In-Hospital Death in Infective Endocarditis,” Circulation, Vol. 109, No. 14, 2004, pp. 1745-1749. doi:10.1161/01.CIR.0000124719.61827.7F
[2] D. R. Murdoch, G. R. Corey, B. Hoen, J. M. Miro, V. G. Fowler Jr., A. S. Bayer, A. W. Karchmer, L. Olaison, P. A. Pappas, P. Moreillon, S. T. Chambers, V. H. Chu, V. Falco, D. J. Holland, P. Jones, J. L. Klein, N. J. Raymond, K. M. Read, M. F. Tripodi, R. Utili, A. Wang, C. W. Woods and C. H. Cabell, “Clinical Presentation, Etiology, and Outcome of Infective Endocarditis in the 21st Century: The International Collaboration on Endocarditis-Prospective Cohort Study,” Archives of Internal Medicine, Vol. 169, No. 5, 2009, pp. 463-473. doi:10.1001/archinternmed.2008.603
[3] M. A. Costa, D. R. Wollmann Jr., A. C. Campos, C. L. Cunha, R. G. Carvalho, D. F. Andrade and D. R. Loures, “Risk Index for Death by Infective Endocarditis: A Multivariate Logistic Model,” Revista Brasileira de Cirurgia Cardiovascular, Vol. 22, No. 2, 2007, pp. 192-200.
[4] Y. Jiang, L. Magli and M. Russo, “Bacterium-Dependent Induction of Cytokines in Mononuclear Cells and Their Pathologic Consequences in Vivo,” Infection and Immunity, Vol. 67, No. 5, 1999, pp. 2125-2130.
[5] J. C. Castillo, M. P. Anguita, M. Ruiz, L. Pena, M. Santisteban, M. Puentes, J. M. Arizon and J. Suarez de Lezo, “Changing Epidemiology of Native Valve Infective Endocarditis,” Revista Espanola de Cardiología, Vol. 64, No. 7, 2011, pp. 594-598.
[6] F. Delahaye, “Is Early Surgery Beneficial in Infective Endocarditis? A Systematic Review,” Archives of Cardiovascular Diseases, Vol. 104, No. 1, 2011, pp. 35-44. doi:10.1016/j.acvd.2010.11.003
[7] V. G. Fowler, Jr., L. L. Sanders, L. K. Kong, R. S. McClelland, G. S. Gottlieb, J. Li, T. Ryan, D. J. Sexton, G. Roussakis, L. J. Harrell and G. R. Corey, “Infective Endocarditis Due to Staphylococcus aureus: 59 Prospectively Identified Cases with Follow-Up,” Clinical Infectious Diseasess, Vol. 28, No. 1, 1999, pp. 106-114. doi:10.1086/515076
[8] P. Moreillon, Y. A. Que and A. S. Bayer, “Pathogenesis of Streptococcal and Staphylococcal Endocarditis,” Infectious Disease Clinics of North America, Vol. 16, No. 2, 2002, pp. 297-318. doi:10.1016/S0891-5520(01)00009-5
[9] M. C. Nunes, C. L. Gelape and T. C. Ferrari, “Profile of Infective Endocarditis at a Tertiary Care Center in Brazil during a Seven-Year Period: Prognostic Factors and In-Hospital Outcome,” International Journal of Infectious Diseases, Vol. 14, No. 5, 2010, pp. e394-e398. doi:10.1016/j.ijid.2009.06.024
[10] G. Habib, L. Badano, C. Tribouilloy, I. Vilacosta, J. L. Zamorano, M. Galderisi, J. U. Voigt, R. Sicari, B. Cosyns, K. Fox and S. Aakhus, “Recommendations for the Practice of Echocardiography in Infective Endocarditis,” European Journal of Echocardiography, Vol. 11, No. 2, 2010, pp. 202-219. doi:10.1093/ejechocard/jeq004
[11] M. Brown and G. E. Griffin, “Immune Responses in Endocarditis,” Heart, Vol. 79, No. 1, 1998, pp. 1-2.
[12] P. Alter, J. Hoeschen, M. Ritter and B. Maisch, “Usefulness of Cytokines Interleukin-6 and Interleukin-2R Concentrations in Diagnosing Active Infective Endocarditis Involving Native Valves,” American Journal of Cardiology, Vol. 89, No. 12, 2002, pp. 1400-1404. doi:10.1016/S0002-9149(02)02353-6
[13] R. W. Watkin, L. V. Harper, A. B. Vernallis, S. Lang, P. A. Lambert, A. M. Ranasinghe and T. S. Elliott, “Pro-Inflammatory Cytokines IL6, TNF-Alpha, IL1Beta, Procalcitonin, Lipopolysaccharide Binding Protein and C-Reactive Protein in Infective Endocarditis,” Journal of Infection, Vol. 55, No. 3, 2007, pp. 220-225. doi:10.1016/j.jinf.2007.05.174
[14] G. Trinchieri, “Cytokines Acting on or Secreted by Macrophages during Intracellular Infection (IL-10, IL-12, IFN-Gamma),” Current Opinion in Immunology, Vol. 9, No. 1, 1997, pp. 17-23. doi:10.1016/S0952-7915(97)80154-9
[15] C. T. Shun, C. Y. Yeh, C. J. Chang, S. H. Wu, H. T. Lien, J. Y. Chen, S. S. Wang and J. S. Chia, “Activation of Human Valve Interstitial Cells by A Viridians Streptococci Modulin Induces Chemotaxis of Mononuclear Cells,” The Journal of Infectious Diseases, Vol. 199, No. 10, 2009, pp. 1488-1496. doi:10.1086/598485
[16] L. Li, J. F. Elliott and T. R. Mosmann, “IL-10 Inhibits Cytokine Production, Vascular Leakage, and Swelling during T Helper 1 Cell-Induced Delayed-Type Hypersensitivity,” The Journal of Immunology, Vol. 153, No. 9, 1994, pp. 3967-3978.
[17] W. V. Kern, A. Engel, S. Schieffer, O. Prummer and P. Kern, “Circulating Tumor Necrosis Factor Alpha (TNF), Soluble TNF Receptors, and Interleukin-6 in Human Subacute Bacterial Endocarditis,” Infection and Immunity, Vol. 61, No. 12, 1993, pp. 5413-5416.
[18] D. T. Durack, A. S. Lukes and D. K. Bright, “New Criteria for Diagnosis of Infective Endocarditis: Utilization of Specific Echocardiographic Findings. Duke Endocarditis Service,” American Journal of Medicine, Vol. 96, No. 3, 1994, pp. 200-209. doi:10.1016/0002-9343(94)90143-0
[19] E. B. Cook, J. L. Stahl, L. Lowe, R. Chen, E. Morgan, J. Wilson, R. Varro, A. Chan, F. M. Graziano and N. P. Barney, “Simultaneous Measurement of Six Cytokines in a Single Sample of Human Tears Using Microparticle-Based Flow Cytometry: Allergics vs. Non-Allergics,” Journal of Immunological Methods, Vol. 254, No. 1-2, 2001, pp. 109-118. doi:10.1016/S0022-1759(01)00407-0
[20] U. Allen, “Infective Endocarditis: Updated Guidelines,” Canadian Journal of Infectious Diseases & Medical Microbiology, Vol. 21, No. 2, 2010, pp. 74-77.
[21] I. Rawczynska-Englert, T. Hryniewiecki and D. Dzierzanowska, “Evaluation of Serum Cytokine Concentrations in Patients with Infective Endocarditis,” Journal of Heart Valve Disease, Vol. 9, No. 5, 2000, pp. 705-709.
[22] I. Sylvester, J. A. Rankin, T. Yoshimura, S. Tanaka and E. J. Leonard, “Secretion of Neutrophil Attractant/Activation Protein by Lipopolysaccharide-Stimulated Lung Macrophages Determined by Both Enzyme-Linked Immunosorbent Assay and N-Terminal Sequence Analysis,” American Review of Respiratory Disease, Vol. 141, No. 3, 1990, pp. 683-688. doi:10.1164/ajrccm/141.3.683

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.