Key result
Benzathine Penicillin G use in rheumatic heart disease patients was associated with significantly lower median IL-1β levels (0.95 vs 5.47 pg/ml, P<0.002).
Why the study?
Valvular inflammation contributes to the progression of rheumatic heart disease, prompting evaluation of the association between inflammatory markers and benzathine penicillin G use in rheumatic mitral valve disease.
Does Benzathine Penicillin G reduce inflammatory cytokine levels in patients with rheumatic mitral valve disease?
Case-Control (n=63)
Does Benzathine Penicillin G reduce inflammatory cytokine levels in patients with rheumatic mitral valve disease?
Absolute Event Rate: 0.95% vs 5.47%
p-value: p=< 0.002
Benzathine penicillin G use as secondary prophylaxis in rheumatic heart disease is associated with significantly lower levels of the inflammatory cytokine IL-1β.
BPG secondary prophylaxis was associated with lower IL-1β in rheumatic mitral valve disease; hypothesis-generating for anti-inflammatory effects, prospective trials needed.
BACKGROUND: Valvular inflammation plays an important role in the progression of Rheumatic Heart Disease. We report the association between inflammatory markers and use of Benzathine Penicillin G in patients with Rheumatic mitral valve disease. METHODS: The levels of inflammatory cytokines; IL-1β, IL-6, TNF-α and inflammatory marker hs- CRP were measured using ELISA method in 32 patients with RHD receiving Benzathine Penicillin as secondary prophylaxis and 31 patients not receiving secondary prophylaxis, in a case-control study. The severity and type of valvular dysfunction were assessed with echocardiogram. RESULTS: The median level of IL-1β was significantly lower in patients on BPG (0.95 pg/ml vs. 5.47 pg/ml) p < 0.002. The median levels of IL-6, TNF-α and hs-CRP were not significantly different between study groups. The adjusted odds of raised IL-1β were lower in patients on BPG (odds ratio 0.40, 95 % C.I. 0.11, 1.45) p 0.16. There was a trend of inverse association between the use of BPG and mitral stenosis (odds ratio 0.42, 95 % C.I. (0.12, 1.46) p 0.17. CONCLUSION: Patients with RHD on BPG had lower levels of IL-1β and a trend toward a lower prevalence of mitral stenosis. Role of IL-1β in progression of incompetent to stenotic mitral valve dysfunction needs to be explored in future studies.
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Kumar et al. (2025) conducted a case-control in Rheumatic Heart Disease (n=63). Benzathine Penicillin G vs. No secondary prophylaxis was evaluated on Median IL-1β level (pg/ml) (p=< 0.002). Benzathine Penicillin G use in rheumatic heart disease patients was associated with significantly lower median IL-1β levels (0.95 vs 5.47 pg/ml, P<0.002).
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