Nephrology Dialysis Transplantation, Vol 12, Issue 4 753-759, Copyright © 1997 by Oxford University Press
J Waiser, K Budde, A Katalinic, M Kuerzdorfer, R Riess and HH Neumayer
BACKGROUND: Interleukin-6 (IL-6) is an inflammatory cytokine that plays a
role in transplant rejection. We tested the hypothesis that IL-6 levels in
serum or urine could be of value in predicting acute and chronic allograft
rejection. Furthermore, we examined whether or not such levels reflected
IL-6 expression in the kidney. METHODS: We measured IL-6 and IL-6 soluble
receptor (IL-6sR) in serum and urine of 145 transplant patients and 20
normal controls. In parallel, we studied 108 renal biopsies. IL-6 was
measured with a bioassay system using an IL-6 dependent cell line. IL-6sR
was measured with enzyme-linked immunosorbent assay. The biopsies were
examined for IL-6 and IL-6 receptor (IL-6R) expression with
immunohistochemistry. RESULTS: Rejection episodes occurring within 2 months
of transplantation were accompanied by elevated IL-6 concentrations in
serum (17 +/- 4.8 pg/ml, P < 0.05) and urine (114 +/- 27 pg/ml, P <
0.005), compared to controls. These values returned towards baseline (0-5
pg/ml) after successful rejection treatment. The sensitivity of urine
measurements was much higher (93%) than serum (54%). The specificity in
serum (70%) and urine (60%) was reduced by infection, acute tubular
necrosis, and antithymocyte globulin treatment. Serum and urine IL-6sR
values did not correlate with rejection. In biopsy tissue, IL-6 and IL-6R
were both elevated during rejection. Especially, mononuclear cells within
the interstitial infiltrate stained positive. However, the amount of IL-6
positive cells did not correlate with peripheral IL-6 concentrations.
CONCLUSIONS: Urine but not serum IL-6 values are sensitive indicators of
rejection; however, they are confounded by infection, acute tubular
necrosis, and certain antirejection treatments. These features limit their
usefulness.
ORIGINAL ARTICLES
Interleukin-6 expression after renal transplantation
Department of Medicine-Nephrology, Medical Clinic V, University Hospital Charite, Humboldt University of Berlin, Germany.
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