Cytokine Production by Peripheral Blood Mononuclear Cells in Renal Transplantation Rejection and Their Effect on Expressions of ICAM-1 and HLA Class II Antigen / 대한내과학회지

ABSTRACT

OBJECTIVES: We examined the levels of IL-1 , IL-6, TNF- , and IFN-gamma in peripheral blood mononuclear cells (PBMC) supernatants of kidney allograft recipients and also investigated the effect of PBMC supernatants on the expressions of HLA Class II antigen and ICAM-1 on endothelial cells. METHODS: PBMC were harvested before grafting, at steady state after grafting (serum creatinine < 2.0 mg/dL), at the onset of acute rejection episodes, and at steady state after rescue from acute rejection episodes. At each step, we examined the levels of cytokines in PBMC supernatants and investigated supernatants induced HLA class II antigen and ICAM-1 expression on cultured umbilical venous endothelial cells. RESULTS: HLA class II antigen and ICAM-1 expression were higher in endothelial cells stimulated with PBMC supernatants from uremic hemodialysis patients (N=10) than from control subjects (N=8). The levels of IL-1 , IL-6, TNF- , and IFN-gamma in PBMC supernatants were higher in uremic hemodialysis patients than in control subjects. In steady state after grafting, significant reductions in the PBMC supernatants induced HLA class II antigen and ICAM-1 expression on endothelial cells and the levels of these cytokines were found. In graft recipients who underwent rejection (N=5), cytokine production by PBMC and PBMC supernatants induced HLA class II antigen and ICAM-1 expression increased at the time of rejection and decreased after treatment of rejection but not significant. CONCLUSION: Cytokine production by PBMC and PBMC supernatants induced HLA class II antigen and ICAM-1 expression were higher in uremic hemodialysis patients than in normal controls. They significantly decrease in steady state after grafting and immunosuppressive therapy was considered as a major factor responsible for that. Further studies ,however, are still required to clarify the roles of cytokines, HLA class II antigen, and ICAM-1 in a series of allograft rejection process.