Gene Expression and Levels of TGF-Β in PBMC Is Associated with Severity of Symptoms in Chronic Heart Failure

Background: tgf-β1 is known to promote cardiac remodeling and fibrosis during congestive heart failure (chf). in this study, an attempt was made to investigate expression of transforming growth factor beta1 (tgf-β1) and relative expansion or contraction of regulatory t-cell (tregs) population in peripheral blood of patients with chronic heart failure (chf). methods: real-time pcr assay was used to investigate expression and post-stimulation levels of tgf-β1 in cell culture supernatant of peripheral blood mononuclear cells (pbmc) of 42 patients with chf and 42 controls. flow cytometry was used to identify relative counts of cd4^+cd25^+foxp^3+ tregs. results: pbmcs in patients with chf expressed higher levels of tgf-β1 compared to controls. post-stimulation levels of tgf-β1 expression were significantly higher in new york heart association (nyha) functional class iv patients compared to stage i patients. tregs were significantly expanded in pbmc in chf, while the cd4^+ helper tcells were unchanged. treg expansion was more significant in nyha functional class i patients compared to class iv patients. conclusion: expansion of treg population in chf provides an extrinsic source for tgf- β1 production to induce reactive fibrosis and cardiac remodeling. relative decrease in treg population at advanced stages of chf is indicative of a loss of regulatory characteristics in these cells and unopposed proinflammatory milieu.