The study of corelationship between the level of immunosuppression and the cytokine levels in kidney transplant recipients.

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The present study examined the effects of CsA administered with steroid in vivo on the capacity of kidney transplant recipient mononuclear cells to generate cytokines and their gene expression at the level messenger RNA(mRNA). Peipherel blood mononuclear cells(PBMC) from CsA-Prednisolon(Pred) treated recipients displayed 40-50% inhibition of IL-2 and 66% inhibition of gamma-IFN production compared with normal individuals. Azathioprine(AZ)-pred treated recipients displayed significantly less inhibition of IL-2 and gamma-INF generation than CsA treated patients. Macrophages(mphi) from CsA-Pred treated recipients also displayed 60.0% inhibition (5.l+O.7 U/ml, n=20, p<0.01) of IL-1 production compared with normal individuals (13.O+2.9U/ml, n=21). These result were confirmed by the experiments using CDNA probe for IL-2, gamma-IFN and IL-l(beta). High levels of IL-2 and gamma-IFN mRNA in PRA-stimulated PBL or IL-1(beta) mRNA in LPS-stimulated mphi were present in normal individuals, but not in CsA treated recipients as judged by hybridization. Moreover, the relationship between the onset of acute rejection crises and the expression of IL-2 or transferrin(TF) receptor on PBL from recipients was investigated.The percentage of lymphocytes expressed IL-2 or transperrin receptor was increased at the onset of acute rejection crises, indicating that the measurement of IL-2 or TF receptor is good indicater for acute rejection crises in kidney transplant recipients.