The effect of etanercept on cardiac transplant recipients: a study of TNFalpha antagonism and cardiac allograft hypertrophy.

Abstract

Cardiac allograft hypertrophy is associated with persistent expression of cardiac tumor necrosis factor (TNF)-alpha. We investigated whether TNFalpha antagonism would impact allograft hypertrophy. EFECT (EFfect of Etanercept on Cardiac Transplantation) was a randomized, controlled, double-blind trial evaluating the effect of etanercept versus placebo treatment immediately posttransplant. The primary end-point was change in left ventricular (LV) mass after 6 months. Secondary endpoints included degree of collagen deposition at 6 months and incidence of adverse events. Forty-nine patients were randomized to either etanercept or placebo. LV mass increased significantly in both arms at 6 months, with a smaller increase in the etanercept group (19% vs. 33%, P=ns). Myocardial collagen content increased in the placebo, but not the etanercept, group (+39.8%, P<0.08 vs. -7.0%, P=NS). Allograft hypertrophy develops posttransplant with a corresponding increase in extracellular matrix. Etanercept appeared to decrease LV hypertrophy by decreasing extracellular matrix deposition.

• Authors: Guillermo Torre-Amione, Cynthia K Wallace, James B Young, Michael M Koerner, Vinay Thohan, Susan McRee, Roberta C Bogaev
• Journal: Transplantation (Transplantation) Vol. 84 Issue 4 Pg. 480-3 (Aug 27 2007) ISSN: 0041-1337 [Print] United States
• PMID: 17713431 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Immunoglobulin G
• Immunosuppressive Agents
• Receptors, Tumor Necrosis Factor
• Tumor Necrosis Factor-alpha
• Collagen
• Etanercept

Topics

• Collagen (metabolism)
• Double-Blind Method
• Etanercept
• Extracellular Matrix (metabolism, pathology)
• Female
• Heart Transplantation (adverse effects, immunology, pathology)
• Heart Ventricles (metabolism, pathology)
• Humans
• Hypertrophy, Left Ventricular (etiology, pathology, prevention & control)
• Immunoglobulin G (adverse effects, therapeutic use)
• Immunosuppressive Agents (adverse effects, therapeutic use)
• Male
• Middle Aged
• Myocardium (metabolism, pathology)
• Receptors, Tumor Necrosis Factor (metabolism, therapeutic use)
• Transplantation, Homologous
• Tumor Necrosis Factor-alpha (antagonists & inhibitors, metabolism)