I would like to know what the concentrations of IL-6 and TNF-a are in a.) Healthy patients, and b.) Patients with NYHA IV heart failure. Links to publications and/or clinical experience would be useful.
Heart failure can be explained in more detail understanding the role of cold-inducible RNA-binding protein (CIRP). CIRP is upregulated in the heart and liver and released into the circulation during a systemic inflammatory response. In macrophages under hypoxic stress, CIRP translocates from the nucleus to the cytosol and is released. Recombinant CIRP stimulates the release of tumor necrosis factor-α (TNF-α) and cytokine from macrophages and induces inflammatory responses and causes tissue injury. The activity of extracellular CIRP is mediated through the Toll-like receptor 4 (TLR4)-myeloid differentiation factor 2 (MD2) complex.