EFFECTS OF TNF-ALPHA INHIBITON ON HEMODYNAMIC PARAMETERS AND BIOMARKERS IN RESISTANT HYPERTENSION. (June 2018)

• Record Type: Journal Article
• Authors: De Faria, A.P.; Santa-Catharina, A.; Ritter, A.; Modolo, R.; Pioli, M.; Pires, N.; Bertolo, M.; Moreno, H.
• Is Part Of: Journal of hypertension. Volume 36(2018)Supplement 1
• Publication Date: 2018-06
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000539092.97172.4f
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: Currently it has been largely discussed the influence of inflammation in resistant hypertension (RH). The blood pressure (BP) variation promotes increased expression of pro-inflammatory cytokines, such as tumor necrosis factor-alpha (TNF-α), interleukins -1 and -6. It was showed that treatment with TNF-α inhibitor improves BP and endothelial function, and reduces arterial stiffness in patients with rheumatoid arthritis. Recently, it was demonstrated that TNF-α levels are increased in RH subjects compared to normotensives. The purpose of this study was to assess whether the acute inhibition of TNF-α (using infliximab infusion) changes hemodynamic parameters, as well as biomarkers in RH. Design and method: This crossover, double-blind study included 10 RH subjects – regularly followed at the Outpatient Resistant Hypertension Clinic (UNICAMP/Brazil) – which were randomized assigned to either (1) serum infusion followed by infliximab infusion (TNF-α inhibitor, 3 mg/kg) or (2) infliximab followed by serum infusion, for two hours and a washout period of 40 days between the infusions. Office, central and ambulatory BP levels, and biomarkers were determined before and after 7 days of infusions. Hemodynamic parameters (determined by Finometer device) was simultaneously assessed during infusions. The plasma concentrations of TNF-α, ILs-1, –6, –10, adiponectin, aldosterone, renin, cortisol were determined by ELISA. Results: Treatment with infliximab increased the delta values of cortisol (3.45 vs. 0.24 ug.dL- 1 ; p = 0.01) and decreased delta renin levels (0.05 vs. 0.25 ng.ml- 1 ; p = 0.03) compared with placebo. Also, TNF-α levels increased after 7 days of infliximab infusion (37.93 ± 38.49 to 110.18 ± 19.54 pg.ml- 1 ; p = 0.01), but did not change with placebo. Delta heart rate values increased after infliximab when compared to placebo (0.89 vs. −1.04 bpm; p = 0.006). No statistical changes were found in either BP parameters evaluated in the study. Conclusions: Our data suggest that the acute inhibition of TNF-α changes hormonal and inflammatory biomarkers although did not modifies hemodynamic parameters in RH subjects.