EVALUATION OF CYTOKINES AND CYTOKINE-INDUCED SECONDARY MESSAGES IN SERA OF PATIENTS AFTER LIVER-TRANSPLANTATION
EVALUATION OF CYTOKINES AND CYTOKINE-INDUCED SECONDARY MESSAGES IN SERA OF PATIENTS AFTER LIVER-TRANSPLANTATION
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DOI：
10.1097/00007890-199006000-00009
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发表时间：
1990-06-01
期刊：
影响因子：
6.2
通讯作者：
HUBER, C
中科院分区：
文献类型：
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作者：
TILG, H;VOGEL, W;HUBER, C
本研究首先探讨原位肝移植术后患者血清肿瘤坏死因子α、白介素1β、干扰素γ、干扰素α、白介素2、β2-微球蛋白(B2M)和尿新喋呤的水平，并探讨其与临床并发症的关系。研究设计为前瞻性观察研究，研究背景为某大学医学中心移植病房。从移植到出院，每隔一天采集20例患者的血清样本。测量和主要结果如下：细胞因子、B2M和新喋呤的浓度是用商业上可用的放射免疫分析方法进行的。在9例急性细胞排斥反应患者中，有7例检测到肿瘤坏死因子-α、干扰素-γ、IL-1、B2M和新喋呤水平升高。巨细胞病毒病患者血清中肿瘤坏死因子-α绝对值最高。除干扰素-γ保持稳定外，细菌感染的增量与上述组相当。血清IL-1水平表现出不同的模式，移植前和排斥期间血清中IL-1浓度达到峰值，而巨细胞病毒病患者的血清IL-1水平逐渐下降。未观察到可检测到的干扰素-α或IL-2水平。我们的结果表明，内源性产生的肿瘤坏死因子-α或IL-2被观察到增强。我们的结果表明，内源性产生的肿瘤坏死因子-α和干扰素-γ的增加伴随着B2M和新喋呤水平的升高是肝移植术后炎性并发症的规律性特征。然而，血清细胞因子水平不能用于区分排斥反应和感染。在检测炎症并发症方面，评价新喋呤比测定细胞因子或B2M更敏感。
The study objective was first to investigate serum levels of tumor necrosis factor alpha, interleukin 1 beta, interferon gamma, interferon alpha, interleukin 2, beta 2-microglobulin (B2M), and urinary neopterin in patients after orthotopic liver transplantation; ans second to relate their levels to clinical complications. The design used was the prospective observation study, and the setting used was the transplant unit of a university medical center. Serum samples were collected from 20 patients every alternate day from transplantation until discharge. The measurements and main results were as follows: concentrations of cytokines, B2M, and neopterin were performed using commercially available radioimmunoassays. In seven out of nine patients with acute cellular rejections, elevated levels of TNF-alpha, IFN-gamma, IL-1, B2M, and neopterin were detected. The highest absolute levels of TNF-alpha were observed in patients with CMV disease. Increments in bacterial infections were comparable to those seen in the above-mentioned groups with the exception of IFN-gamma, which remained stable. IL-1 serum levels showed a different pattern with peak concentrations measured in sera before transplant and during rejection, while in the case of CMV disease levels gradually decreased. No detectable levels of IFN-alpha or IL-2 were observed. Our results indicate that enhanced endogenous production of TNF-alpha or IL-2 were observed. Our results indicate that enhanced endogenous production of TNF-alpha and IFN-gamma accompanied by elevated levesl fo B2M and neopterin represent a regulaar feature of inflammatory complications after liver transplantation. Serum cytokine levels however were not useful in distinguishing between rejections and infection. Evaluation of neopterin was more sensitive than cytokine or B2M measurement for the detection of inflammatory complications.