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Impact of cardiac resynchronization therapy on circulating IL-17 producing cells in patients with advanced heart failure

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Purpose

IL-17-producing T cells have been implicated in the inflammatory milieu of chronic heart failure (CHF), which implies a dismal prognosis in affected patients. The aim of this study was to evaluate the impact of cardiac resynchronization therapy (CRT) on the frequency and functional activity of Th17 and Tc17 cells, as well as, on IL-17 mRNA expression in patients with CHF.

Methods

Twenty-eight patients with CHF, analyzed before CRT (T0) and 6 months later (T6), and 15 healthy controls (HC) were enrolled in this study. Circulating Th17 and Tc17 cells were evaluated by flow cytometry. The quantification of IL-17A mRNA expression was performed by real-time PCR.

Results

Circulating Tc17 cells tended to be higher in CHF patients submitted to CRT than in HC (0.92% (0.24–3.32) versus 0.60% (0.09–3.68), although not reaching statistical significance. The frequency of Tc17 cells in CHF patients significantly decreases after CRT reaching levels similar to those of HC (0.92% (0.24–3.32) at T0 versus 0.56% (0.21–4.20) at T6, P < 0.05), mainly due to responders to CRT. Additionally, the expression of IL-17 mRNA was detected in a few number of responder patients at T0 (27%) and only detected in one responder at T6 (7%). Conversely, in non-responders, the proportion of patients exhibiting IL-17 mRNA expression increases from baseline (17%) to T6 (42%). No significant differences were observed in Th17 cells between HC, CHF patients in T0 and patients in T6.

Conclusion

The inflammatory response mediated by circulating IL-17 producing cells seems to be suppressed by CRT, particularly in responders.

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Funding

This study received financial support from the PEst-OE/SAU/UI0709/2014 project.

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Authors and Affiliations

  1. CICS-UBI – Centro de Investigação em Ciências da Saúde, Universidade da Beira Interior, Covilhã, Portugal

    Sílvia Martins & Cândida Tomaz

  2. Coimbra Institute for Clinical and Biomedical Research, Faculdade de Medicina, Coimbra, Portugal

    Sílvia Martins, Paula Laranjeira & Artur Paiva

  3. Centro do Sangue e da Transplantação de Coimbra, Instituto Português do Sangue e da Transplantação, Coimbra, Portugal

    Tiago Carvalheiro & António Martinho

  4. Flow Cytometry Unit, Department of Clinical Pathology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal

    Paula Laranjeira & Artur Paiva

  5. Cardiology Department, Coimbra Hospital and Universitary Centre, Coimbra, Portugal

    Luís Elvas, Lino Gonçalves & Natália António

  6. Faculty of Medicine, Coimbra University, Coimbra, Portugal

    Luís Elvas, Lino Gonçalves & Natália António

  7. Departamento de Química, Universidade da Beira Interior, Covilhã, Portugal

    Cândida Tomaz

  8. Instituto Politécnico de Coimbra, ESTESC - Coimbra Health School, Ciências Biomédicas Laboratoriais, Coimbra, Portugal

    Artur Paiva

  9. Unidade de Gestão Operacional de Citometria, Serviço de Patologia Clínica, Centro Hospitalar e Universitário de Coimbra, Ed. S. Jerónimo, Praceta Mota Pinto, 3001-301, Coimbra, Portugal

    Artur Paiva

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  1. Sílvia Martins
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  2. Tiago Carvalheiro
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Correspondence to Artur Paiva.

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The authors declare that they have no conflict of interest.

Ethical approval

The study was performed in accordance with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards and the research protocol was approved by the local Ethical Committee.

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All the studied patients gave and signed the informed consent.

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Martins, S., Carvalheiro, T., Laranjeira, P. et al. Impact of cardiac resynchronization therapy on circulating IL-17 producing cells in patients with advanced heart failure. J Interv Card Electrophysiol 54, 257–265 (2019). https://doi.org/10.1007/s10840-018-0491-3

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  • DOI: https://doi.org/10.1007/s10840-018-0491-3

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