Inflammatory cytokine levels in rheumatic heart disease and their association with use of benzathine penicillin: A case-control pilot study
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Date
2025-04
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Publisher
Elsevier
Abstract
Background: Valvular inflammation plays an important role in the progression of Rheumatic Heart Disease. We report the association between inflammatory markers and use of Benzathine Penicillin G in patients with Rheumatic mitral valve disease. Methods: The levels of inflammatory cytokines; IL-1?, IL-6, TNF-? and inflammatory marker hs- CRP were measured using ELISA method in 32 patients with RHD receiving Benzathine Penicillin as secondary prophylaxis and 31 patients not receiving secondary prophylaxis, in a case–control study. The severity and type of valvular dysfunction were assessed with echocardiogram. Results: The median level of IL-1? was significantly lower in patients on BPG (0.95 pg/ml vs. 5.47 pg/ml) p < 0.002. The median levels of IL-6, TNF-? and hs-CRP were not significantly different between study groups. The adjusted odds of raised IL-1? were lower in patients on BPG (odds ratio 0.40, 95 % C.I. 0.11, 1.45) p 0.16. There was a trend of inverse association between the use of BPG and mitral stenosis (odds ratio 0.42, 95 % C.I. (0.12, 1.46) p 0.17. Conclusion: Patients with RHD on BPG had lower levels of IL-1? and a trend toward a lower prevalence of mitral stenosis. Role of IL-1? in progression of incompetent to stenotic mitral valve dysfunction needs to be explored in future studies.
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Keywords
C-Reactive protein, Cytokines, Interleukin-1beta, Interleukin-6, Penicillin G benzathine rheumatic heart disease, Rheumatic fever, Tumor necrosis factor-alpha
Citation
Kumar Sanjeev, Negi Prakash Chand, Asotra Sanjeev, Chandel Meenakshi, Kumar Jitender, Merwah Rajeev, Sharma Rajesh, Kumar Ritesh, Bhardwaj Vinay, Thakur Preetam Singh. Inflammatory cytokine levels in rheumatic heart disease and their association with use of benzathine penicillin: A case-control pilot study. Indian Heart Journal. 2025 Apr; 77(2): 59-62