Die Bedeutung von Zytokinen bei der Entstehung einer Herzinsuffizienz

 

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Zusammenfassung

Die chronische Herzinsuffizienz trägt wesentlich zur Mortalität und Morbidität in der westlichen Zivilisation bei. Bisherige Arbeitshypothesen zur Pathogenese der Herzinsuffizienz beantworten die Fragen nach den Ursachen der Krankheit und ihrer Progression nur unzureichend.

Erst kürzlich konnte gezeigt werden, dass im Rahmen einer Herzinsuffizienz eine Gruppe von Polypeptiden, so genannte Zytokine, vermehrt exprimiert werden und eine wesentliche Rolle für die Pathogenese der Erkrankung spielen. Experimentelle Untersuchungen haben gezeigt, dass Zytokine die linksventrikuläre Pumpfunktion beeinflussen und für charakteristische Merkmale der Herzinsuffizienz verantwortlich sein könnten. Ihre Expression wird durch die Applikation von bestimmten ACE-Hemmern, β-Blockern und Angiotensin Rezeptor Typ 1 Antagonisten moduliert.

Der vorliegende Artikel resümiert verschiedene sowohl experimentelle und klinische Untersuchungen als auch pharmakologische Ansätze zur Therapie der chronischen Herzinsuffizienz. Die bisherigen Ergebnisse zeigen, dass es von besonderer Bedeutung ist, weitere antiinflammatorische Ansätze zur Therapie der chronischen Herzinsuffizienz zu untersuchen.

Abstract

Chronic heart failure is a major cause for mortality and morbidity in western civilizations. Previous hypothesises regarding the pathogenesis of chronic heart failure did not sufficiently explain the aetiology and the progression of the disease.

However, it has been shown that a group of peptides called cytokines are expressed during chronic heart failure and that cytokines might play an important role for the pathogenesis. The expression of cytokines can be modulated from specific ACE-inhibitors as well as from different β-blockers and angiotensin type 1 antagonists. Numerous investigations have shown that cytokines depress left ventricular function and can be responsible for different characteristics of chronic heart failure.

The present article resumes experimental and clinical investigations and recent pharmacologic attempts for the treatment of chronic heart failure. The previous results demonstrate the importance to further investigate anti-inflammatory approaches to treat chronic heart failure.

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Dr. med. G. Baumgarten

Klinik für Anästhesiologie und spezielle Intensivmedizin der Rheinischen Friedrich-Wilhelms-Universität, Bonn

Sigmund-Freud-Straße 25 · 53105 Bonn ·

Email: Georg.Baumgarten@ukb.uni-bonn.de