Key result
Blocking TNF-α with etanercept partially attenuates LV fibrosis and remodeling in arthritic rats.
Why the study?
The mechanisms of inflammation-induced left ventricular remodeling and the effects of blocking circulating TNF-α in systemic inflammation were not fully determined.
Does etanercept reduce left ventricular fibrosis and remodeling in a rat model of systemic inflammation?
Does etanercept reduce left ventricular fibrosis and remodeling in a rat model of systemic inflammation?
In a rat model of systemic inflammation, TNF-α inhibition with etanercept partially attenuated left ventricular fibrosis and extracellular matrix remodeling.
Answers are grounded in this paper and cite their sources.
Should not yet change practice for cardiac fibrosis; hypothesis-generating for TNF-α inhibition in inflammatory remodeling.
OBJECTIVE: To determine the mechanisms of inflammation-induced left ventricular (LV) remodeling and effects of blocking circulating tumor necrosis factor alpha (TNF-α) in a model of systemic inflammation. METHODS: Seventy Sprague-Dawley rats were divided into three groups: the control group, the collagen-induced arthritis (CIA) group, and the anti-TNF-α group. Inflammation was induced in the CIA and anti-TNF-α groups. Following the onset of arthritis, the anti-TNF-α group received the TNF-α inhibitor, etanercept, for 6 weeks. LV geometry and function were assessed with echocardiography. Circulating inflammatory markers were measured by ELISA and LV gene expression was assessed by comparative TaqMan® polymerase chain reaction. RESULTS: The LV relative gene expression of pro-fibrotic genes, transforming growth factor β (TGFβ) (p = 0.03), collagen I (Col1) (p < 0.0001), and lysyl oxidase (LOX) (p = 0.002), was increased in the CIA group compared with controls, consistent with increased relative wall thickness (p = 0.0009). Col1 and LOX expression in the anti-TNF-α group were similar to controls (both, p > 0.05) and tended to be lower compared to the CIA group (p = 0.06 and p = 0.08, respectively), and may, in part, contribute to the decreased relative wall thickness in the anti-TNF-α group compared to the CIA group (p = 0.03). In the CIA group, the relative gene expression of matrix metalloproteinase 2 (MMP2) and MMP9 was increased compared to control (p = 0.04) and anti-TNF-α (p < 0.0001) groups, respectively. CONCLUSION: Chronic systemic inflammation induces fibrosis and dysregulated LV extracellular matrix remodeling by increasing local cardiac pro-fibrotic gene expression, which is partially mediated by TNF-α. Inflammation-induced LV diastolic dysfunction is likely independent of myocardial fibrosis.
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Manilall et al. (2021) studied Systemic inflammation and left ventricular remodeling (n=70). Etanercept (TNF-α inhibitor) vs. Control and collagen-induced arthritis (CIA) groups was evaluated on Left ventricular relative gene expression of pro-fibrotic genes and LV geometry/function. Blocking TNF-α with etanercept for 6 weeks in rats with collagen-induced arthritis partially attenuated inflammation-induced left ventricular fibrosis and extracellular matrix remodeling.
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