Potential mechanisms of benefit with thalidomide in chronic heart failure.

摘要: This review considers the recent clinical and relevant preclinical evidence that thalidomide may have therapeutic benefit in chronic heart failure (HF), some of mechanisms by which elicit potentially beneficial effects. Persistent inflammation, involving increased levels inflammatory cytokines, seems to play a pathogenic role HF influencing contractility, inducing matrix degradation fibrosis, promoting apoptosis, contributing myocardial remodeling. On basis these issues, immunomodulating therapy has emerged as an option management HF. Failure anti-tumor necrosis factor (TNF) lead further interest more general immunomodulatory approach, directed against imbalanced cytokine network rather than at one particular cytokine.Some studies suggest thalidomide, glutamic acid derivative with proposed antiangiogenic, anti-inflammatory, properties, should be added list potential agents Thus, double-blind, placebo-controlled study patients HF, was found significantly improve left ventricular ejection fraction. Although been regarded anti-TNF drug, it increase plasma TNFalpha suggesting other contribute its Such could involve inhibition neutrophils, stabilizing, antifibrotic effects, well thalidomide-mediated decrease rate. However, our knowledge action this drug is still scarce will examined forthcoming studies. include experiments animal models trials, attempting identify human