Serum & urinary interleukin-2 levels as predictors in acute renal allograft rejection.

BACKGROUND & OBJECTIVES: In spite of potent immunosuppression, acute rejection continues to be the single largest cause of graft dysfunction after renal transplantation. Renal allograft biopsy, though invasive, continues to be the reference standard, though certain clinical and biochemical parameters are helpful in assessment of these patients. Acute renal allograft rejection is mediated by T lymphocytes, which express increased number of interleukin-2 receptors (IL-2R). The soluble component of IL-2R in serum and urine may be useful in detecting early graft rejection. This study assesses the possibility of using serum and urinary IL-2R estimation in early prediction and diagnosis of acute renal allograft rejection. METHODS: Sequential estimation of serum and urinary IL-2R levels along with serum creatinine values were assessed in 23 live related renal allograft recipients. The age of renal allograft recipients was 35+/-8.3 yr, with male:female ratio of 22:1. Samples were collected pre-transplant (day 0) and post-transplant upto 30 days and the patients were followed for 6 months after transplantation. Eight recipients experienced graft dysfunction and graft biopsies were evaluated. RESULTS: Serum and urinary IL-2R patterns along with serum creatinine levels were correlated with the occurrence of graft rejection on histology. Eight recipients experienced acute graft rejection after transplantation and 15 had stable graft function. Serum IL-2R levels at various periods after transplantation were found to be significantly (P<0.05) elevated in graft recipients experiencing acute rejection as compared to the non-rejection group. The rise in urinary IL-2R levels in some of the rejection group recipients, was not statistically significant. INTERPRETATION & CONCLUSION: Sequential serum and urinary IL-2R assay may serve as a predicter for early graft dysfunction. Study with larger sample size and for longer duration is required to further validate the results.

Soluble interleukin-2 receptor [sIL-2R] in some hematologic malignancies

The aim of this study was to evaluate serum levels of sIL-2R in some of the hematologic malignancies and to find out if it could be a predictive marker of tumor burden and response to therapy. The mean value of sIL-2R in ALL was significantly elevated than in the controls. It was also significantly high in the patients with activity as compared with those at remission. Also, the mean value of sIL-2R in NHL was significantly elevated compared with the controls. Newly diagnosed cases had a high mean serum value of sIL-2R compared with those under treatment and a more significant elevation in comparison with the cases at remission. Also, patients under treatment showed a significantly higher mean serum value of sIL-2R than patients at remission. In patients with HL the mean value of sIL-2R was significantly elevated as compared with the controls. Newly diagnosed cases with HL had a significantly high mean serum value of sIL-2R as compared with patients under treatment and at remission. Also, patients under treatment showed a significantly high mean serum value of sIL-2R compared with those at remission

Effect of polyadenylic.polyuridylic acid on cellular responses of peripheral blood mononuclear cells from patients with chronic active hepatitis B

We have investigated in vitro proliferative responses of peripheral blood mononuclear cells and productions of interferon-gamma and soluble interleukin-2 receptors by these cells from 6 patients with chronic active hepatitis B immediately before and 24 hours after a single intravenous injection of 100 mg of polyadenylic.polyuridylic acid. Cell proliferations were assessed by the technique of tritiated-thymidine incorporation and productions of interferon-gamma and soluble interleukin-2 receptors were measured by enzyme-linked immunosorbent assay. The administration of polyadenylic.polyuridylic acid to the patients has resulted in significant increases of in vitro proliferations of their peripheral blood mononuclear cells as well as productions of interferon-gamma by these cells. However, in vitro productions of soluble interleukin-2 receptors were not changed significantly. These results suggest that the enhanced cellular responses by polyadenylic.polyuridylic acid might be due to the increased sensitivity rather than the increased expression of cellular interleukin-2 receptor.