Inflammation-induced left ventricular fibrosis is partially mediated by tumor necrosis factor-α

Ashmeetha Manilall, Lebogang Mokotedi, Sulè Gunter, Regina Le Roux, Serena Fourie, Colleen A Flanagan, Aletta M E Millen

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


OBJECTIVE: To determine the mechanisms of inflammation-induced left ventricular (LV) remodeling and effects of blocking circulating tumor necrosis factor alpha (TNF-α) in a model of systemic inflammation.

METHODS: Seventy Sprague-Dawley rats were divided into three groups: the control group, the collagen-induced arthritis (CIA) group, and the anti-TNF-α group. Inflammation was induced in the CIA and anti-TNF-α groups. Following the onset of arthritis, the anti-TNF-α group received the TNF-α inhibitor, etanercept, for 6 weeks. LV geometry and function were assessed with echocardiography. Circulating inflammatory markers were measured by ELISA and LV gene expression was assessed by comparative TaqMan® polymerase chain reaction.

RESULTS: The LV relative gene expression of pro-fibrotic genes, transforming growth factor β (TGFβ) (p = 0.03), collagen I (Col1) (p < 0.0001), and lysyl oxidase (LOX) (p = 0.002), was increased in the CIA group compared with controls, consistent with increased relative wall thickness (p = 0.0009). Col1 and LOX expression in the anti-TNF-α group were similar to controls (both, p > 0.05) and tended to be lower compared to the CIA group (p = 0.06 and p = 0.08, respectively), and may, in part, contribute to the decreased relative wall thickness in the anti-TNF-α group compared to the CIA group (p = 0.03). In the CIA group, the relative gene expression of matrix metalloproteinase 2 (MMP2) and MMP9 was increased compared to control (p = 0.04) and anti-TNF-α (p < 0.0001) groups, respectively.

CONCLUSION: Chronic systemic inflammation induces fibrosis and dysregulated LV extracellular matrix remodeling by increasing local cardiac pro-fibrotic gene expression, which is partially mediated by TNF-α. Inflammation-induced LV diastolic dysfunction is likely independent of myocardial fibrosis.

Original languageEnglish
Pages (from-to)e15062
JournalPhysiological Reports
Issue number21
Publication statusPublished - Nov 2021


  • Animals
  • Anti-Inflammatory Agents/pharmacology
  • Arthritis, Experimental/drug therapy
  • Arthritis, Rheumatoid/drug therapy
  • Etanercept/pharmacology
  • Fibrosis
  • Heart Ventricles/drug effects
  • Rats
  • Rats, Sprague-Dawley
  • Tumor Necrosis Factor-alpha/antagonists & inhibitors
  • Ventricular Remodeling


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