Therefore, different ranges of IL-6 levels in ESHF-patients needing a LVAD support, might differently affect the redox processes and immune BKM120 response to stress stimuli succeeding LVAD implantation, thus influencing the clinical course and early outcome. Kirsh et al. reported that a low percentage of monocytes expressing HLA-DR molecules, during the immediate phase of device support, was predictive of ICU-death, suggesting that a low percentage of HLA-DR positive monocytes reflects a postoperative immunoparalysis that hampers tissue repair processes necessary for end-organ recovery. HLA-DR expression is reported as a phenotypic marker of functional monocyte deactivation, making controversial clinical interpretation of the monitoring of neopterin in LVAD-patients. However, the concomitant presence of reduced proportions of CD14+ HLA-DR cells with elevated levels of neopterin was reported in trauma patients and sepsis, together proposed as biomarkers reflecting an immune response, not balanced, susceptible to favors sepsis and adverse MOF. Therefore, the elevated levels of neopterin and IL-8 found in our LVAD-patients with a poorer outcome might reflect an altered monocyte-mediated immune response, influenced by pre-implant IL-6 levels. Our single centre study was limited by its relatively small number of patients; the results are not related to a single device but to different CF-LVADs. However, the findings of this study underscore the importance to consider the inflammatory parameters related with monocyte activation during the decision making process of ESHF-patients, to deepen the knowledge of clinical features of patients and better stratify the operative risk, and the risk of MOF or death after LVAD implantation. Finally, preoperative elevated IL-6 levels, higher than 8.3 pg/ mL, are associated, after intervention, to higher release of markers related with the monocyte activation, prolonged course and poorer outcome. Further studies in larger population are needed to validate the cut-off value of IL-6 and of other potential biomarkers which could be helpful in targeting the most appropriate treatment. They are abundant in neuronal tissues and associated with the pathogenesis of neurodegenerative diseases. Although physiological functions of synucleins are not entirely understood, there are hints that a, b and c-synuclein possess chaperon like activity. Studies show a mutated form of a-synuclein in patients with autosomal dominant Parkinson disease and as a component of plaques in Alzheimer patients. Furthermore a-synuclein is a component of Lewy bodies in Parkinsons disease. All synucleins are expressed in retina and optic nerve. c-synuclein is involved in neurodegenerative and ocular diseases and is highly expressed in retinal ganglion cells. In comparison to healthy people, the optic nerve head and retina of glaucoma patients show different c-synuclein localizations. Glaucoma is a heterogeneous neurodegenerative disease defined by a progressive loss of rgc, optic nerve degeneration and progressive visual field loss, which finally can lead to blindness.