SINOPSIS

Between pro- and anti-inflammatory components of the human immune system there is a dynamic balance, violation of which is an important mechanism in the pathogenesis of many pathological states, including cardiac insufficiency. The study was aimed at investigation of cytokine secretion by the mononuclear cells in patients with acute myocardial infarction, without (the 1^st group) and with (the 2^nd group) acute heart failure, and determination of the balance between pro- (TNF-α, IL-6, IL-8) and anti-inflammatory (IL-10) factors in the development of acute heart failure. The study has shown that in patients of the 1^st group there is initially high level of both pro-inflammatory cytokines and anti-inflammatory cytokine IL-10. In dynamics of monitoring, to the 10^th day, the content of IL-6 reduced, but the level of TNF-α and IL-10 increases. Patients of the 2^nd group demonstrate initially high content of TNF-α and IL-6, while the content of IL-8 and IL-10 is lower compared with patients of the 1^st group. In this group of patients, a further increase in the content of all proinflammatory cytokines and a decrease in anti-inflammatory IL-10 are recorded. Balance between pro- and anti-inflammatory cytokines reflects an inflammatory activity index, as determined by the formula (TNF-α + IL-6 + IL-8) / IL-10, and testifies to normal cytokine balance in patients of group 1, accompanied by a decrease in the index, whereas in patients of the 2^nd group this index increases by the 10^th day.