A. Moutabarrik et al., INTERLEUKIN-1 AND ITS NATURALLY-OCCURRING ANTAGONIST IN PERITONEAL-DIALYSIS PATIENTS, Clinical nephrology, 43(4), 1995, pp. 243-248
We have assessed the levels of interleukin-lb (IL-lb) and interleukin-
l receptor antagonist (IL-1RA) in both serum and peritoneal dialysate
effluents (PDE) from nineteen continuous ambulatory peritoneal dialysi
s patients (CAPD) without peritonitis and three CAPD patients with per
itonitis. IL-1 beta and IL-1RA were tested using a specific ELISA immu
ne-assay. Fifteen normal healthy volunteers served as control. The ser
um levels of IL-1RA in CAPD patients were significantly increased comp
aratively to their levels in healthy volunteers (p <0.001). CAPD patie
nts without peritonitis (stable patients) showed relatively low levels
of IL-1RA in peritoneal dialysate effluents (114.4 +/- 85.1 pg/ml). P
atients with peritonitis showed very high serum levels of IL-1RA at th
e onset of acute infection (4710 +/- 50 pg/ml). The levels of IL-IRA i
n PDE were very high during the onset of bacterial peritonitis (5744 /- 254 pg/ml). The clinical recovery from peritonitis was char acteriz
ed by a fall in IL-1RA in both serum and dialysate. Serum levels IL-1
beta showed a different pattern, it was not detectable in stable CAPD
patients as well as in normal healthy volunteers. It was detectable on
ly in serum of patients with peritonitis (10 +/- 0.8 pg/ml). Likewise,
in most stable patients, IL-1 beta-PDE levels were not detectable, bu
t. substantial amounts can be detected in PDE during bacterial infecti
on (80 +/- 15 pg/ml). The increase in serum and PDE levels of IL-1 bet
a during bacterial infection was very rapid, this cytokine disappeared
in serum and PDE, 2 or 3 days before the clinical recovery. This stud
y has demonstrated that CAPD procedure and its complications lead to t
he production of small amounts of IL-1 beta but a large amounts of IL-
1RA. The increased production of IL-1RA is a better indicator of the h
ost response to CAPD-induced systemic inflammation than IL-1.