ELEVATED CIRCULATING LEVELS OF INTERLEUKIN-6 IN PATIENTS WITH CHRONIC-RENAL-FAILURE
ELEVATED CIRCULATING LEVELS OF INTERLEUKIN-6 IN PATIENTS WITH CHRONIC-RENAL-FAILURE
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DOI：
10.1038/ki.1991.120
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发表时间：
1991-05-01
影响因子：
19.6
通讯作者：
DESCAMPSLATSCHA, B
中科院分区：
文献类型：
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作者：
HERBELIN, A;URENA, P;DESCAMPSLATSCHA, B
在之前的一项研究中，我们证明了长期透析患者中存在循环白细胞介素-1 (IL-1)，以及长期和尚未透析的尿毒症患者中存在肿瘤坏死因子α (TNF-α)。 在本研究中，我们试图确定血液透析 (HD) 和尿毒症对血浆白介素 6 (IL-6) 水平的影响，IL-6 与 IL-1 和 TNF-α 具有多种生物学特性，包括诱导炎症过程的急性期反应。 使用生物和免疫反应测定法对 48 名终末期肾衰竭患者（包括 32 名长期 HD 患者和 16 名接受首次透析的慢性尿毒症患者）进行了血浆 IL-6 检测。 与正常人相比，慢性肾功能衰竭患者的血浆IL-6活性显着升高（P<0.001）。 然而，长期和尚未透析的患者之间没有观察到差异。 在 IL-6 活性最显着的患者中，检测到免疫反应性 IL-6 水平在 60 至 150 pg/ml 之间。 在IL-6生物测定中，抗人IL-6的单克隆抗体(mAb)抑制血浆活性，且IL-6的生物活性与其免疫反应水平之间存在密切相关性。 在第一次透析过程以及随后的透析过程中，未检测到血浆 IL-6 的变化。 同样，观察了装备透析器的透析膜的性质（纤维素或合成聚丙烯腈）的影响。 然而，与透析前水平相比，长期 HD 患者在透析结束后四小时测得血浆 IL-6 显着增加，这与首次透析患者测得的相对下降形成鲜明对比。 最后，在长期 HD 患者中，最大血浆 IL-6（透析后 4 小时测量）和最大血浆 IL-1（透析结束时测量）之间存在显着相关性。 从这些结果中，我们得出结论，尿毒症本身是血浆 IL-6 升高的主要原因，并且与重复透析过程相关的因素（包括 IL-1）可能有助于维持血浆 IL-6 水平升高。
In a previous study, we demonstrated the presence of circulating interleukin-1 (IL-1) in long-term dialyzed patients and that of tumor necrosis factor alpha (TNF-alpha) in both long-term and not yet dialyzed uremic patients. In the present study, we attempted to determine the respective influence of hemodialysis (HD) and uremia on the plasma level of interleukin-6 (IL-6), which shares several biological properties with IL-1 and TNF-alpha, including the induction of the acute phase response of the inflammatory process. Forty-eight patients with end-stage renal failure, including 32 long-term HD patients and 16 chronic uremic patients undergoing their first dialysis session, were tested for plasma IL-6 using both biological and immunoreactive assays. Plasma IL-6 activity was significantly increased in patients with chronic renal failure (P < 0.001) compared to its level in normal individuals. No difference was observed, however, between long-term and not yet dialyzed patients. In the patients with the most pronounced IL-6 activity, immunoreactive IL-6 levels between 60 and 150 pg/ml were detected. A monoclonal antibody (mAb) against human IL-6 inhibited the activity of plasma in the IL-6 bioassay, and a close correlation existed between the biological activity of IL-6 and its immunoreactive level. No change in plasma IL-6 was detected during the course of the first dialysis as well as subsequent sessions. Likewise, to influence of the nature (cellulosic or synthetic polyacrilonitrile) of the dialysis membrane equipping the dialyzer was observed. However, compared to predialysis levels, a significant increase in plasma IL-6 was measured four hours following the end of the dialysis session in long-term HD patients, thus contrasting with the relative decrease measured in first-dialyzed patients. Lastly, in long-term HD patients, there was a significant correlation between maximum plasma IL-6 (measured 4 hr postdialysis) and maximum plasma IL-1 (measured at the end of the dialysis session). From these results, we conclude that uremia per se is the principal origin of increased plasma IL-6 and that factors related to repeated dialysis procedure including IL-1 may contribute in maintaining increased plasma levels of IL-6.