THE VALUE OF POSTTRANSPLANT MONITORING OF INTERLEUKIN (IL)-2, IL-3, IL-4, IL-6, IL-8, AND SOLUBLE CD23 IN THE PLASMA OF RENAL-ALLOGRAFT RECIPIENTS

Over the past few years, the central role of cytokines in the amplific ation of the immune response has been reported and several studies hav e examined the relationship between the plasma level of individual lym phokines during renal allograft rejection. The aim of the present inve stigation was to study simultaneously IL-2, IL-3, IL-4, IL-6, IL-8, an d soluble CD23. Analysis of results has allowed both the prognostic va lue and any possible interrelationships between the measured cytokines to be determined. We studied 16 renal transplant recipients for the f irst 14 days after transplantation. Seven patients showed clinical evi dence of acute allograft rejection and 5 showed excellent stable graft function with no signs of rejection. Primary nonfunction was seen in 4 patients. The plasma levels of each cytokine were measured by commer cially available ELISA and immunoradiometric assay kits. As reported i n previous studies, plasma IL-2 levels, whenever found at detectable l evels, were predictive of impending graft rejection. Serial monitoring of IL-4 and IL-6 was more reliable for the differential diagnosis of rejection, particularly toward the end of the first week after transpl antation. IL-3, IL-8, and soluble CD23 were not diagnostic or predicti ve of rejection, due to the occurrence of significantly high levels in transplant patients who showed no evidence of clinical rejection. Whi le the value of cytokine monitoring has been shown in this study, it s hould be remembered that infection, although not seen in these studies , may have a profound affect on the results obtained.