title: Production of interleukin-6, tumor necrosis factor alpha and interleukin-10 in vitro correlates with the clinical immune defect in chronic hemodialysis patients.
abstract: In patients with chronic renal failure alterations in monokine production are a common feature. Their clinical relevance has not yet been proven. We show here a correlation between an overproduction of interleukin-(IL)-6 and tumor necrosis factor alpha (TNF alpha) upon stimulation with LPS by mononuclear cells in vitro and the clinical grade of immunodeficiency found in these patients. Higher levels of IL-6 and TNF alpha were correlated with an immunocompromized state, that is, non-responsiveness to hepatitis B vaccination, whereas patients with a better immune competence showed the same levels of these cytokines as healthy controls. Only the patients with a good immune function showed a high secretion of IL-10. The feedback mechanism of IL-10 for reducing monokine synthesis seems to be intact in these patients. Thus the secretion of IL-10 might be regarded as a compensatory mechanism which controls monokine induction by chronic renal failure and hemodialysis treatment. Immunocompromized patients who are unresponsive to hepatitis B vaccination seem to be unable to enhance IL-10 synthesis for control of monokine overproduction. This results in higher levels of IL-6 and TNF alpha that might be involved in the pathogenesis of reduced immune defense.
authors.affiliation: Medical Department IV, University of Homburg/Saar, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Girndt
authors.forename: H
authors.initials: H
authors.lastname: Köhler
authors.forename: E
authors.initials: E
authors.lastname: Schiedhelm-Weick
authors.forename: J F
authors.initials: JF
authors.lastname: Schlaak
authors.forename: K H
authors.initials: KH
authors.lastname: Meyer zum Büschenfelde
authors.forename: B
authors.initials: B
authors.lastname: Fleischer
mesh_terms: D000911:Antibodies, Monoclonal / Q000276:immunology; D001483:Base Sequence; D006509:Hepatitis B / Q000517:prevention & control; D006801:Humans; D007154:Immune System Diseases / Q000378:metabolism*; D016753:Interleukin-10 / Q000096:biosynthesis* / Q000276:immunology / Q000494:pharmacology; D015850:Interleukin-6 / Q000096:biosynthesis* / Q000097:blood; D008070:Lipopolysaccharides / Q000494:pharmacology; D008969:Molecular Sequence Data; D015846:Monokines / Q000378:metabolism; D015345:Oligonucleotide Probes / Q000235:genetics; D011994:Recombinant Proteins; D006435:Renal Dialysis; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis*; D014611:Vaccination
chemical_list: D000911:Antibodies, Monoclonal; D015850:Interleukin-6; D008070:Lipopolysaccharides; D015846:Monokines; D015345:Oligonucleotide Probes; D011994:Recombinant Proteins; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10