Effects of malignancy and interleukin-2 infusion on gut macromolecular permeability.
OBJECTIVE
Enhanced gut permeability has been shown in patients with advanced malignancy. The dramatic inflammatory shock syndrome produced by high-dose interleukin-2 immune therapy could further change gut barrier function. This study measured the effect of advanced renal cell carcinoma and malignant melanoma, and interleukin-2 treatment on gut permeability.


METHODS
Nonrandomized, controlled study.


METHODS
University hospital.


METHODS
Adults with metastatic, unresectable renal cell carcinoma or metastatic, malignant melanoma, and normal volunteers.


METHODS
Gut permeability was measured in patients with renal cell carcinoma or malignant melanoma before and during interleukin-2 infusions, using polyethylene glycol 3350 and polyethylene glycol 400. The polyethylene glycols were administered orally within 48 hrs of interleukin-2 therapy and the 24-hr urine excretions were measured.


RESULTS
Increased permeability was seen in the baseline state of these patients (ratio of polyethylene glycol 3350 to polyethylene glycol 400 = 1.1 +/- 0.7 x 10(-2)) when compared with normal volunteers (ratio = 0.48 +/- 0.2 x 10(-2); p < .05). However, after interleukin-2 treatment, no further increase in permeability was seen (ratio = 1.4 +/- 0.8 x 10(-2)).


CONCLUSIONS
Gut permeability to polyethylene glycol 3350 is enhanced in advanced malignancy. High-dose interleukin-2 therapy does not further increase permeability of the gut.
Ryan
C M
CM
Surgical Service, Massachusetts General Hospital, Boston 02114, USA.
Atkins
M B
MB
Mier
J W
JW
Gelfand
J A
JA
Tompkins
R G
RG
D000328:Adult; D002292:Carcinoma, Renal Cell / Q000378:metabolism* / Q000628:therapy; D004064:Digestive System / Q000187:drug effects / Q000378:metabolism; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007262:Infusions, Intravenous; D007376:Interleukin-2 / Q000008:administration & dosage*; D007408:Intestinal Absorption / Q000187:drug effects*; D007680:Kidney Neoplasms / Q000378:metabolism* / Q000628:therapy; D008297:Male; D008545:Melanoma / Q000378:metabolism* / Q000628:therapy; D008875:Middle Aged; D010539:Permeability / Q000187:drug effects; D011092:Polyethylene Glycols / Q000493:pharmacokinetics
D007376:Interleukin-2; D011092:Polyethylene Glycols