Dynamic changes in soluble interleukin-2 receptor levels after lung or heart-lung transplantation.
Activation of T-lymphocytes is accompanied by the release of interleukin-2 receptors (IL-2R) in a soluble form that can be measured as an index of the activation process. We performed a prospective, blinded study of the dynamic changes in soluble IL-2R levels in serum in 12 patients undergoing lung or heart-lung transplantation. The levels of soluble IL-2R were markedly elevated during episodes of rejection (geometric mean value X divided by SEM = 3,770 X divided by 1.06 versus 411 X divided by 1.08 U/ml for normal controls, p less than 0.0001). Levels of soluble IL-2R were 2,105 X divided by 1.16 U/ml with rejection episodes in single lung recipients versus 5,560 X divided by 1.30 in recipients of two lungs (p = 0.005). Soluble IL-2R levels were 1,468 X divided by 1.05 during episodes of nonbacterial infections, 1,879 X divided by 1.34 with bacterial infections, and 5,056 X divided by 1.08 with sepsis (p less than 0.001 for each category compared to normals). Levels of soluble IL-2R exceeded 6,750 U/ml only with rejection episodes and were greater than 4,100 U/ml either with rejection, clinical sepsis, or overwhelming bacterial infection. We conclude that marked elevations of soluble IL-2R are associated with rejection, intermediate elevations with either rejection or infection, and that low levels of soluble IL-2R exclude rejection.
Lawrence
E C
EC
Rockwell-McKelvey Immunology Laboratory, Methodist Hospital, Houston, TX 77030.
Holland
V A
VA
Young
J B
JB
Windsor
N T
NT
Brousseau
K P
KP
Noon
G P
GP
Whisennand
H H
HH
Debakey
M E
ME
Nelson
D L
DL
D000328:Adult; D002986:Clinical Trials as Topic; D005260:Female; D006084:Graft Rejection; D016027:Heart Transplantation; D016041:Heart-Lung Transplantation; D006801:Humans; D007239:Infections / Q000378:metabolism; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000378:metabolism; D011446:Prospective Studies; D015375:Receptors, Interleukin-2 / Q000378:metabolism*; D012995:Solubility
D015375:Receptors, Interleukin-2