Induction of cytokine expression in leukocytes in acute myocardial infarction

Objectives. This study sought to investigate whether cytokine expression in leukocytes may be induced by plasma from the reperfused heart of patients with an acute myocardial infarction (MI). Background. Reperfusion in acute MI is associated with deleterious local and systemic inflammatory responses that are regulated by cytokines. Induction of cytokine expression in resident leukocytes could contribute to inflammatory responses of the ischemic and reperfused heart. Methods. Blood samples of 10 patients with an acute MI were obtained simultaneously from the coronary sinus and the aorta before and 5 min after recanalization of the coronary occlusion. Ten patients with elective percutaneous transluminal coronary angioplasty served as a control group. We incubated leukocytes from healthy donors with plasma samples and analyzed mRNA expression of interleukin (IL)-l(beta), IL-6, IL-8 and tumor necrosis factor-alpha (TNF-alpha) by Northern blot analysis. Results. In patients with an acute MI, plasma obtained from the coronary sinus after recanalization increased the mRNA expression of IL-1(beta) and IL-8 compared with that of plasma before recanalization (median [quartiles] difference before vs. after recanalization: 34.5 [4, 137], p = 0.017, for IL-l(beta); 18.5 [4, 35], p = 0.032, for IL-8) and simultaneously obtained aortic plasma (median [quartiles] coronary sinus-aortic differences after recanalization: 45.5 [-3, 115], p = 0.021, for IL-1(beta); 16 [4, 52], p = 0.005, for IL-8). No induction of IL-6 and TNF-alpha expression could be observed. No changes found in the study patients were detectable in the control group. Conclusions. Plasma from the ischemic and reperfused heart stimulates the expression of IL-1(beta) and IL-8 in leukocytes. Therefore, leukocyte- derived cytokines may contribute to the regulation of cardiac inflammatory responses in patients with an acute MI.