Nephrology Dialysis Transplantation, Vol 13, Issue 7 1662-1667, Copyright © 1998 by Oxford University Press
V Tesar, Z Masek, I Rychlik, M Merta, J Bartunkova, A Stejskalova, J Zabka, I Janatkova, T Fucikova, C Dostal and R Becvar
Background: Plasma levels of some pro-inflammatory
cytokines and soluble adhesion molecules have been suggested to be useful
parameters to assess the activity of antineutrophil cytoplasmic antibody
(ANCA)-positive vasculitis and lupus nephritis. We hypothesized that the
renal activity of these diseases is better reflected by the urinary
excretion and fractional excretion of these molecules.
Methods: Plasma levels and urinary excretion of tumour
necrosis factor-&agr; (TNF-&agr;), interleukin (IL)-6, IL-8, and
the soluble cell adhesion molecules sICAM-1 and sVCAM-1 were measured by
enzyme-linked immunosorbent assay (ELISA) in 15 patients with ANCA-positive
renal vasculitis (eight active, ANCA-A; six in remission, ANCA-R), six
patients with active lupus nephritis (LN), 15 patients with IgA nephropathy
(IgAN) and nine healthy subjects. Fractional excretion of selected
cytokines and adhesion molecules was also calculated.
Results: Patients with ANCA-A had increased urinary
excretion and fractional excretion of TNF-&agr; (9.27±3.19%
vs 0.58±0.02%, P<0.01), IL-6
(120.79±65.83% vs 1.89±0.34%,
P<0.01) and increased fractional excretion of IL-8
(23.34±6.38% vs 2.56±1.07%,
P<0.01) and sVCAM-1 (0.81±0.33% vs
0.03±0.02%, P<0.01) compared with controls. Urinary
excretion of TNF-&agr; and IL-6 and fractional excretion of
TNF-&agr;, IL-6 and IL-8 were higher in ANCA-A than in ANCA-R. Patients
with LN had increased plasma TNF-&agr; (20.52±2.01 pg/ml
vs 12.33±0.23 pg/ml, P<0.05) and
sVCAM-1 (1537.88±276.36 ng/ml vs
692.26±44.42 ng/ml, P<0.05) and increased urinary
excretion of TNF-&agr; (2.81±0.51 &mgr;g/mol creat
vs 0.98±0.05 &mgr;g/mol creat,
P<0.01), IL-8 (35.78±14.03 &mgr;g/mol creat
vs 12.46±5.19 &mgr;g/mol creat,
P<0.05) and sVCAM-1 (48.98±20.20 &mgr;g/mol creat
vs 2.92±1.35 &mgr;g/mol creat,
P<0.01) compared with controls. Patients with IgAN had, in
comparison with controls only increased plasma TNF-&agr;
(18.10±0.57 pg/ml vs 12.33±0.23
pg/ml, P<0.05). Conclusions: Urinary excretion
and fractional excretion, but not plasma levels of selected proinflammatory
cytokines (TNF-&agr;, IL-6 and IL-8) were increased in patients with
active ANCA-positive renal vasculitis, but not in ANCA positive vasculitis
in remission. These parameters may be useful to monitor the activity of
this disease. Key words: interleukins; lupus
nephritis; renal vasculitis; tumour necrosis factor-&agr;
ORIGINAL ARTICLES
Cytokines and adhesion molecules in renal vasculitis and lupus nephritis
1st Department of Medicine, 3rd Department of Medicine, Institute of Clinical Immunology, 1st Institute of Pathological Anatomy, 1st School of Medicine, Charles University, and Institute of Rheumatology, Prague, Czechoslovakia; Corresponding author at: Division of Nephrology, 1st Department of Medicine, Charles University, U nemocnice 2, 128 08 Praha 2, Czechoslovakia
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