INTERLEUKIN-10, INTERFERON-GAMMA, INTERLEUKIN-2, AND SOLUBLE INTERLEUKIN-2 RECEPTOR-ALPHA DETECTED DURING PERITONITIS IN THE DIALYSATE AND SERUM OF PATIENTS ON CONTINUOUS AMBULATORY PERITONEAL-DIALYSIS

Objective: To analyze interleukin (IL)-10, interferon gamma (IFN-gamma ), IL-2, and soluble IL-2 receptor alpha (sIL-2R alpha) in the dialysa te and serum of patients on continuous ambulatory peritoneal dialysis (CAPD). Design and Patients: Samples from dialysate bags were collecte d during the initial month of dialysis. During peritonitis, samples we re collected from the first three bags on the day of admittance to the hospital and from the night bags on days 3 and 10. Serum samples were drawn on days 1 and 10. Results: IL-10 was detected in all dialysate samples except one on the first day of infection, with a peak median l evel of 50 pg/mL and a slow decrease thereafter. In serum the median l evels never exceeded detectable levels. Patients infected with Escheri chia coli or Staphylococcus aureus had higher IL-10 levels in dialysat e on day 3 as compared to the remaining patients (p < 0.05). If the ca theter had to be drawn, because of persistent cloudy dialysate, the IL -10 levels remained elevated for a longer time (0 < 0.05). IFN-gamma a nd IL-2 were detected only in the dialysate of patients infected with either S. aureus or S. epidermidis. Only one serum sample showed incre ased IFNn-gamma. SIL-2R alpha was found in all the serum and dialysis samples from the first day of infection. Contrary to the analyzed cyto kines, the receptor showed severalfold higher levels in serum as compa red to the dialysate. During the infection the receptor levels in the dialysate increased, while they remained stationary in the serum, indi cating a local production. Conclusion: This is the first time IL-10 ha s been demonstrated in the dialysate during peritonitis in CAPD patien ts. In view of its role as a suppressor of the immune and inflammatory responses, it is a potentially important observation, which might hav e clinical implications in the future.