ABSTRACT
This study was aimed to investigate the correlation between the serum levels of IL-18 and acute graft versus host disease (aGVHD) in patients received allogeneic hematopoietic stem cell transplantation (allo-HSCT), and to explore the role of serum IL-18 levels in the pathogenesis of aGVHD so as to provide a reliable and early indicator for the diagnosis of aGVHD. 62 patients received allo-HSCT were enrolled in this study. Before and after transplantation, as well as at onset of aGVHD. The serum levels of IL-18 were analyzed by ELISA. 62 patients were divided into 5 groups: group A without aGVHD (28 cases) referred to the patients who had no aGVHD after transplantation and whose specimen were collected before transplantation; group B with aGVHD before transplantation (34 cases) referred to the patients who had aGVHD after transplantation and whose specimen were collected before transplantation; group C before the onset of aGVHD (34 cases) referred to patients with I - II grade a GVHD whose specimen were collected before 3 - 4 days, and according to whether the I - II grade aGVHD patients developed III - IV grade or not after treatment, these patients were divided into two subgroups retrospectively, one subgroup had good curative effect (18 cases) and the other subgroup had not (16 cases); group D with I - II grade aGVHD; group E with III - IV grade aGVHD (16 cases). The results showed that 34 patients developed I - II grade aGVHD, then out of them 16 patients (16/34) developed III - IV grade aGVHD. The serum levels of IL-18 in these patients with aGVHD were higher than that in patients without aGVHD. About 3 days before onset of aGVHD, the serum levels of IL-18 started to increase. The serum levels of IL-18 were correlated with the severity of aGVHD, but no correlation was found with infection, conditioning regimens and disparity of HLA-typing. The serum levels of IL-18 in the early stage of aGVHD were correlated with prognosis. The aGVHD of patients with higher serum levels of IL-18 easy developed to III - IV grade aGVHD. It is concluded that the serum level of IL-18 in the patients received allo-HSCT is related to the occurrence of aGVHD. Detections of serum IL-18 are helpful for the early diagnosis of aGVHD, and the serum levels of IL-18 may be considered as a reliable indicator to evaluate the prognosis and severity of aGVHD.