THE RELATION OF INTERLEUKIN-6, TUMOR-NECROSIS-FACTOR-ALPHA, IL-2, AND IL-2 RECEPTOR LEVELS TO CELLULAR REJECTION, ALLOGRAFT DYSFUNCTION, AND CLINICAL EVENTS EARLY AFTER CARDIAC TRANSPLANTATION

被引：58

作者：

DENG, MC ^{[1
]}

ERREN, M ^{[1
]}

KAMMERLING, L ^{[1
]}

GUNTHER, F ^{[1
]}

KERBER, S ^{[1
]}

FAHRENKAMP, A ^{[1
]}

ASSMANN, G ^{[1
]}

BREITHARDT, G ^{[1
]}

SCHELD, HH ^{[1
]}

机构：

[1] MUNSTER UNIV HOSP, DEPT THORAC & CARDIOVASC SURG, D-48129 MUNSTER, GERMANY

来源：

TRANSPLANTATION | 1995年 / 60卷 / 10期

关键词：

D O I：

10.1097/00007890-199511270-00011

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Immunoregulatory cytokines have been implicated in the pathophysiology of graft dysfunction after heart transplantation (HTx). In 15 consecutive patients undergoing HTx we prospectively determined levels of interleukin-6 (IL-6), tumor-necrosis-factor-alpha (TNF-alpha), interleukin-2 (IL-2), and soluble-interleukin-2-receptor (sIL-2-R) at eight points in time during biopsy and right heart catheterization and within 12 hr of echocardiography during the first three months after HTx. Blood was taken from the pulmonary arterial line. IL-6-levels correlated positively with hemodynamic and echocardiographic parameters of pump dysfunction-namely, pulmonary capillary wedge pressure, pulmonary arterial pressure, right atrial pressure, heart rate-and negatively with isovolumic relaxation time and stroke volume independent of the degree of cellular rejection as classified by the ISHLT criteria, A similar pattern was found for TNF-alpha- and sIL-2-R, while IL-2 correlated negatively with left and right heart filling pressures and positively with fractional shortening, In the three patients who died of sepsis or multiorgan failure within the study period IL-6-, TNF-alpha, and sIL-2-R-levels were elevated and IL-2-levels were suppressed compared with the 12 patients with a stable clinical course, IL-6 and sIL-2-R correlated positively while IL-6 and IL-2 correlated negatively, In this pilot study, a cytokine pattern with elevated levels of IL-6, TNF-alpha, and sIL-2-R as well as suppressed levels of IL-2 in the early period after HTx corresponds to impaired hemodynamics independent of cellular rejection and may indicate an unfavorable prognosis, These cytokines may therefore be useful for monitoring and warrant further study.

引用

页码：1118 / 1124

页数：7

共 44 条

[1] Valantine H.A., Rejection surveillance by Doppler echocardiogra phy, J Heart Lung Transplant, 12, (1993)
[2] Valantine H.A., Johnson F., Dong C., Et al., Cytokines as potential mediators of acute allograft diastolic dysfunction: A pilot study using in-situ-hybridization, J Heart Lung Transplant, 13, (1994)
[3] Fyfe A., Daly P., Galligan L., Pirc L., Feindel C., Cardella C., Cor onary sinus sampling of cytokines after heart transplantation: Evidence for macrophage activation and interleukin-4-produc-tion within the graft, J Am Coll Cardiol, 21, (1993)
[4] Billingham M.E., Cary N., Hammond E., Et al., A working formu lation for the standardization of nomenclature in the diagnosis of heart and lung transplant rejection: Heart rejection study group, J Heart Transplantation, 9, (1990)
[5] Park J.W., Warnecke H., Deng M., Schuler S., Heinrich K.W., Hetzer R., Early diastolic left ventricular function as a marker of acute cardiac rejection: A prospective serial echocardiographic study, Int J Cardiol, 37, (1992)
[6] Valantine H.A., Fowler M.B., Hunt S.A., Et al., Changes in Doppler echocardiographic indexes of left ventricular function as potential markers of acute cardiac rejection, Circulation, 76, (1987)
[7] Waage A., Halstensen A., Espevik T., Association between tumor necrosis factor in serum and fatal outcome in patients with meningococcal disease, Lancet, 1, (1987)
[8] Marty C., Misset B., Tamion F., Fitting C., Carlet J., Cavaillon J.M., Circulating interleukin-8 concentrations in patients with multiple organ failure of septic and nonseptic origin, Crit Care Med, 22, (1994)
[9] Moscovitz H., Shofer F., Mignott H., Behrmann A., Kilpatrick L., Plasma cytokine determinations in emergency department patients as a predictor of bacteremia and infectious disease severity, Crit Care Med, 22, (1994)
[10] Termuhlen D.F., Pennington D.G., Roodman S.T., Et al., T cells in ventricular assist device patients, Circulation, 80, pp. 111-174, (1989)

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