Document Detail

Toll-like receptor 4 mediates maladaptive left ventricular remodeling and impairs cardiac function after myocardial infarction.
MedLine Citation:
PMID:  18007026     Owner:  NLM     Status:  MEDLINE    
Left ventricular (LV) remodeling leads to congestive heart failure and is a main determinant of morbidity and mortality following myocardial infarction. Therapeutic options to prevent LV remodeling are limited, which necessitates the exploration of alternative therapeutic targets. Toll-like receptors (TLRs) serve as pattern recognition receptors within the innate immune system. Activation of TLR4 results in an inflammatory response and is involved in extracellular matrix degradation, both key processes of LV remodeling following myocardial infarction. To establish the role of TLR4 in postinfarct LV remodeling, myocardial infarction was induced in wild-type BALB/c mice and TLR4-defective C3H-Tlr4(LPS-d) mice. Without affecting infarct size, TLR4 defectiveness reduced the extent of LV remodeling (end-diastolic volume: 103.7+/-6.8 microL versus 128.5+/-5.7 microL; P<0.01) and preserved systolic function (ejection fraction: 28.2+/-3.1% versus 16.6+/-1.3%; P<0.01), as assessed by MRI. In the noninfarcted area, interstitial fibrosis, and myocardial hypertrophy were reduced in C3H-Tlr4(LPS-d) mice. In the infarcted area, however, collagen density was increased, which was accompanied by fewer macrophages, reduced inflammation regulating cytokine expression levels (interleukin [IL]-1alpha, IL-2, IL-4, IL-5, IL-6, IL-10, IL-17, tumor necrosis factor-alpha, interferon-gamma, granulocyte/macrophage colony-stimulating factor), and reduced matrix metalloproteinase-2 (4684+/-515 versus 7573+/-611; P=0.002) and matrix metalloproteinase-9 activity (76.0+/-14.3 versus 168.0+/-36.2; P=0.027). These data provide direct evidence for a causal role of TLR4 in postinfarct maladaptive LV remodeling, probably via inflammatory cytokine production and matrix degradation. TLR4 may therefore constitute a novel target in the treatment of ischemic heart failure.
Leo Timmers; Joost P G Sluijter; J Karlijn van Keulen; Imo E Hoefer; Marcel G J Nederhoff; Marie-Jose Goumans; Pieter A Doevendans; Cees J A van Echteld; Jaap A Joles; Paul H Quax; Jan J Piek; Gerard Pasterkamp; Dominique P V de Kleijn
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-11-15
Journal Detail:
Title:  Circulation research     Volume:  102     ISSN:  1524-4571     ISO Abbreviation:  Circ. Res.     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-02-01     Completed Date:  2008-03-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0047103     Medline TA:  Circ Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  257-64     Citation Subset:  IM    
Department of Cardiology, University Medical Center, Utrecht, The Netherlands.
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MeSH Terms
Cytokines / genetics
Gene Expression Regulation
Heart / physiopathology
Heart Failure / therapy
Myocardial Infarction / physiopathology*
Stroke Volume
Toll-Like Receptor 4 / deficiency,  physiology*
Ventricular Remodeling*
Reg. No./Substance:
0/Cytokines; 0/Tlr4 protein, mouse; 0/Toll-Like Receptor 4
Comment In:
Circ Res. 2008 Feb 1;102(2):137-9   [PMID:  18239139 ]

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