A critical analysis of serum and urine interleukin-2 receptor assays in renal allograft recipients.
A component of the interleukin 2 receptor (IL-2R) is released in soluble form during T cell activation and can be detected in the blood during acute renal allograft rejection. This study evaluates the diagnostic utility of a sandwich enzyme immunoassay test for serum and urine IL-2R in renal allograft recipients. A rise in serum IL-2R during the week prior to the clinical diagnosis of rejection correlated better with rejection than did isolated serum IL-2R levels or urine values. For the diagnosis of acute rejection, a rise in serum IL-2R (sensitivity 73%, specificity 87%) was comparable in overall test performance to a rise in serum creatinine (sensitivity 70%, specificity 84%). Overall, the two tests had equivalent receiver operating characteristic curves. Because the etiology of false positives in creatinine and IL-2R assays differed (primarily cyclosporine toxicity and infection, respectively), the predictive value of the combined tests was superior to either alone.
Colvin
R B
RB
Immunopathology Unit, Massachusetts General Hospital, Boston 02114.
Preffer
F I
FI
Fuller
T C
TC
Brown
M C
MC
Ip
S H
SH
Kung
P C
PC
Cosimi
A B
AB
D003404:Creatinine / Q000097:blood; D003524:Cyclosporins / Q000633:toxicity; D003602:Cytotoxicity, Immunologic; D006084:Graft Rejection; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology*; D011446:Prospective Studies; D015375:Receptors, Interleukin-2 / Q000097:blood* / Q000652:urine*
D003524:Cyclosporins; D015375:Receptors, Interleukin-2; D003404:Creatinine