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Published online April 4, 2008
Diabetes Care 31:1439-1441, 2008
DOI: 10.2337/dc08-0219
© 2008 by the American Diabetes Association
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Cardiovascular and Metabolic Risk
Original Research

Tumor Necrosis Factor-{alpha} Antagonism Improves Vasodilation During Hyperinsulinemia in Metabolic Syndrome

Manfredi Tesauro, MD1, Francesca Schinzari, MD2, Valentina Rovella, MD1, Domenico Melina, MD2, Nadia Mores, MD2, Angela Barini, MD2, Marco Mettimano, MD2, Davide Lauro, MD1, Micaela Iantorno, MD3, Michael J. Quon, MD, PHD3 and Carmine Cardillo, MD2

1 Università di Tor Vergata, Rome, Italy
2 Università Cattolica del Sacro Cuore, Rome, Italy
3 National Center for Complementary and Alternative Medicine, National Institutes of Health, Bethesda, Maryland

Corresponding author: Carmine Cardillo, carmine.cardillo{at}rm.unicatt.it

OBJECTIVE—Obesity is associated with chronic inflammation due to overproduction of proinflammatory cytokines, including tumor necrosis factor (TNF)-{alpha}. We assessed the effects of TNF-{alpha} neutralization by infliximab on vascular reactivity during hyperinsulinemia in obesity-related metabolic syndrome.

RESEARCH DESIGN AND METHODS—Vascular responses to intra-arterial infusion of acetylcholine (ACh) and sodium nitroprusside (SNP) were assessed in patients with metabolic syndrome, before and after administration of infliximab.

RESULTS—Patients had blunted vasodilator responses to ACh and SNP during hyperinsulinemia compared with control subjects; a potentiation of the responsiveness to both ACh and SNP, however, was observed in patients following infliximab. The antioxidant vitamin C improved the vasodilator response to ACh in patients with metabolic syndrome, but its effect was not further enhanced by concurrent administration of infliximab.

CONCLUSIONS—TNF-{alpha} neutralization ameliorates vascular reactivity in metabolic syndrome during hyperinsulinemia, likely in relation to decreased oxidative stress, thereby suggesting an involvement of inflammatory cytokines in vascular dysfunction of these patients.


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Copyright © 2008 by the American Diabetes Association.