Do ACE-inhibitors suppress tumour necrosis factor-alpha production in advanced chronic renal failure?

@article{citeulike:2965773, abstract = {OBJECTIVES: The serum levels of the catabolic cytokine TNF-alpha are often raised in malnourished chronic heart failure patients as well as in chronic renal failure (CRF) patients. Angiotensin-converting enzyme (ACE) inhibitors are often used in these patients and may decrease TNF-alpha and IL-1beta levels in vitro and in vivo. The aim of this study was to find out whether CRF patients with ongoing ACE-inhibitor treatment have lower TNF-alpha levels. DESIGN: Cross-sectional study. SETTING: Tertiary Referral Center and University Hospital. SUBJECTS: Ninety-six predialysis patients (mean age 52 +/- 1 years) with advanced CRF (glomerular filtration rate 7 +/- 1 mL min-1). MAIN OUTCOME MEASURES: Plasma levels of TNF-alpha, subjective global assessment of nutritional status and data on ongoing antihypertensive treatment (ACE-inhibitors, beta blockers, calcium channel blockers and angiotensin II (AII) receptor blockers). RESULTS: Patients treated with ACE-inhibitors (n = 44) had significantly lower plasma TNF-alpha levels (18.5 +/- 1.2 vs. 26.6 +/- 2.2 pg mL-1; P < 0.01) and were less frequently malnourished, relative to 52 patients not treated with ACE-inhibitors. No significant difference in TNF-alpha levels were observed when comparing patients with or without treatment with beta, calcium channel, or AII receptor blockers, respectively. CONCLUSIONS: The present data suggest that the use of ACE-inhibitors is associated with lower plasma TNF-alpha and CRP levels as well as a lower prevalence of malnutrition in patients with advanced CRF. Further studies are needed to establish if there is a casual relationship between these findings and, if so, the molecular mechanism(s).}, address = {Division of Renal Medicine, Department of Clinical Science, Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden. peter.stenvinkel@klinvet.ki.se}, author = {Stenvinkel, P. and Andersson, P. and Wang, T. and Lindholm, B. and Bergstr\"{o}m, J. and Palmblad, J. and Heimb\"{u}rger, O. and Cederholm, T. }, citeulike-article-id = {2965773}, issn = {0954-6820}, journal = {Journal of internal medicine}, keywords = {acei, ckd, inflammation}, month = {November}, number = {5}, pages = {503--507}, posted-at = {2008-07-05 10:43:49}, priority = {2}, title = {Do ACE-inhibitors suppress tumour necrosis factor-alpha production in advanced chronic renal failure?}, url = {http://view.ncbi.nlm.nih.gov/pubmed/10583720}, volume = {246}, year = {1999} }

TY - JOUR ID - citeulike:2965773 L3 - citeulike-article-id:2965773 TI - Do ACE-inhibitors suppress tumour necrosis factor-alpha production in advanced chronic renal failure? JF - Journal of internal medicine VL - 246 IS - 5 SP - 503 EP - 507 AD - Division of Renal Medicine, Department of Clinical Science, Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden. peter.stenvinkel@klinvet.ki.se SN - 0954-6820 N2 - OBJECTIVES: The serum levels of the catabolic cytokine TNF-alpha are often raised in malnourished chronic heart failure patients as well as in chronic renal failure (CRF) patients. Angiotensin-converting enzyme (ACE) inhibitors are often used in these patients and may decrease TNF-alpha and IL-1beta levels in vitro and in vivo. The aim of this study was to find out whether CRF patients with ongoing ACE-inhibitor treatment have lower TNF-alpha levels. DESIGN: Cross-sectional study. SETTING: Tertiary Referral Center and University Hospital. SUBJECTS: Ninety-six predialysis patients (mean age 52 +/- 1 years) with advanced CRF (glomerular filtration rate 7 +/- 1 mL min-1). MAIN OUTCOME MEASURES: Plasma levels of TNF-alpha, subjective global assessment of nutritional status and data on ongoing antihypertensive treatment (ACE-inhibitors, beta blockers, calcium channel blockers and angiotensin II (AII) receptor blockers). RESULTS: Patients treated with ACE-inhibitors (n = 44) had significantly lower plasma TNF-alpha levels (18.5 +/- 1.2 vs. 26.6 +/- 2.2 pg mL-1; P < 0.01) and were less frequently malnourished, relative to 52 patients not treated with ACE-inhibitors. No significant difference in TNF-alpha levels were observed when comparing patients with or without treatment with beta, calcium channel, or AII receptor blockers, respectively. CONCLUSIONS: The present data suggest that the use of ACE-inhibitors is associated with lower plasma TNF-alpha and CRP levels as well as a lower prevalence of malnutrition in patients with advanced CRF. Further studies are needed to establish if there is a casual relationship between these findings and, if so, the molecular mechanism(s). KW - acei KW - ckd KW - inflammation AU - Stenvinkel, P AU - Andersson, P AU - Wang, T AU - Lindholm, B AU - Bergström, J AU - Palmblad, J AU - Heimbürger, O AU - Cederholm, T PY - 1999/11// UR - http://view.ncbi.nlm.nih.gov/pubmed/10583720 ER -