Decrease of circulating myeloid dendritic cells in patients with chronic heart failure

AIMS: Immunity and inflammation processes are known to be of central importance in chronic heart failure (CHF). Dendritic cells (DCs) are key players in adaptive immunity, yet their role in CHF is still unknown. The aim of this study was to investigate the circulating DCs in patients with compensated CHF. METHODS: Circulating myeloid (m) and plasmacytoid (p) DCs, as well as inflammatory cytokines interleukine (IL) 6 and IL10 were flow cytometrically analysed in peripheral blood of clinically compensated CHF patients with previously diagnosed dilated cardiomyopathy (DCM, n = 69), ischaemic cardiomyopathy (ICM, n = 49), as well as in unaffected controls (n = 51). Correlation analysis was performed between circulating DCs, cytokines and parameters of heart failure severity, such as NYHA class, the marker brain natriuretic peptide (BNP) and echocardiographic parameters of left ventricular function and dilation. RESULTS: Circulating mDCs were significantly decreased in all CHF patients, although more pronounced in DCM (0.14%, P < 0.001) than in ICM (0.18%, P = 0.043) compared to controls (0.2%). In contrast, no statistical changes were observed for pDCs. Circulating mDCs correlated with left ventricular ejection fraction (LVEF) and inversely with LV end-diastolic diameter (LVEDd) in all CHF patients. For DCM patients, an inverse correlation of mDCs with BNP was additionally observed. Circulating mDCs correlated inversely with IL6 and IL10 in all CHF patients. With the exception of IL-6 and NYHA class of DCM patients, cytokines did not significantly correlate with heart failure parameters. CONCLUSIONS: Blood mDCs are decreased in CHF patients. The reduction correlates with the severity of their HF.