title: A comparison of the cardiopulmonary effects of continuous versus bolus infusion of recombinant interleukin-2 in sheep.
abstract: The systemic administration of recombinant interleukin-2 (rIL-2) is used for the treatment of patients with far advanced cancer. However, treatment may be limited by a so-called "third space" syndrome. Whether these side effects are due to the total dose used or the method of administration is unclear. To define whether the continuous (Group 2) or bolus (Group 3) i.v. infusion of 9 x 10(5) units/kg rIL-2 over 72 h is associated with similar toxicities, we established a chronic sheep model and monitored changes in systemic and pulmonary vascular pressures, cardiac function, and gas exchange. At 72 h lung lymph flow, lymph/plasma protein ratios, lung histology, and extravascular lung water/dry lung weight were obtained. In both groups the infusion of rIL-2 resulted in an increase in high protein lung lymph flow, an increase in cardiac output, and a decrease in systemic vascular resistance. Large lymphoid cells were found by histology to be infiltrating the lung interstitium. In Group 2, in addition, there were mild pulmonary hypertension [pulmonary artery pressures increased from 14 +/- 5 to 22 +/- 6 mmHg (P less than 0.05)], systemic hypotension [81 +/- 7 compared to a baseline of 95 +/- 9 mmHg (P less than 0.01)], and worsening gas exchange. We conclude that a 72-h continuous or bolus infusion of equivalent doses of rIL-2 are associated with cardiopulmonary toxicity; however, pulmonary hypertension, systemic hypotension, and gas exchange are worse in animals receiving the continuous infusion.
authors.affiliation: Pulmonary Division, Medical College of Virginia, Richmond 23298.
authors.forename: F L
authors.initials: FL
authors.lastname: Glauser
authors.forename: G G
authors.initials: GG
authors.lastname: DeBlois
authors.forename: D E
authors.initials: DE
authors.lastname: Bechard
authors.forename: R E
authors.initials: RE
authors.lastname: Merchant
authors.forename: A J
authors.initials: AJ
authors.lastname: Grant
authors.forename: A A
authors.initials: AA
authors.lastname: Fowler
authors.forename: R P
authors.initials: RP
authors.lastname: Fairman
mesh_terms: D000818:Animals; D001794:Blood Pressure / Q000187:drug effects; D001831:Body Temperature / Q000187:drug effects; D006321:Heart / Q000187:drug effects*; D007262:Infusions, Intravenous; D007376:Interleukin-2 / Q000008:administration & dosage / Q000633:toxicity*; D008168:Lung / Q000187:drug effects* / Q000473:pathology; D011659:Pulmonary Gas Exchange / Q000187:drug effects; D011994:Recombinant Proteins / Q000633:toxicity; D012756:Sheep
chemical_list: D007376:Interleukin-2; D011994:Recombinant Proteins