Interleukin-6 and neopterin in renal transplant recipients: a longitudinal study.
Serum and urine interleukin-6 (IL-6) levels and serum neopterin/creatinine ratios were longitudinally studied in 86 renal transplant recipients until 4 months after transplantation. During acute rejection and acute tubular necrosis (ATN), serum and urine IL-6 levels were elevated compared to during stable transplant function (P < 0.001). During acute rejection, serum IL-6 levels increased at least 2 days before plasma creatinine started to rise (P < 0.05), indicating its early involvement in the rejection process. During cytomegalovirus (CMV) disease, serum, but not urine, IL-6 levels were higher (P < 0.01), and serum neopterin/creatinine values were higher than during stable transplant function, ATN, or acute rejection (P < 0.01). No significant differences with stable transplant function occurred during cyclosporin A toxicity. Measurement of serum IL-6 provided a sensitivity of 84% and a specificity of 85% for the diagnosis of acute rejection episodes not coinciding with ATN. All cases of CMV disease could be diagnosed by measurement of serum neopterin/creatinine, which provided a specificity of 73%.
Department of Internal Medicine, University of Amsterdam, The Netherlands.
M H
MH
Raasveld
E
E
Bloemena
J M
JM
Wilmink
S
S
Surachno
P T
PT
Schellekens
R J
RJ
ten Berge
D000328:Adult; D000368:Aged; D001708:Biopterins / Q000031:analogs & derivatives* / Q000097:blood; D003404:Creatinine / Q000097:blood; D016572:Cyclosporine / Q000627:therapeutic use; D003586:Cytomegalovirus Infections / Q000097:blood / Q000652:urine; D005260:Female; D006084:Graft Rejection / Q000097:blood / Q000517:prevention & control / Q000652:urine; D006801:Humans; D015850:Interleukin-6 / Q000097:blood* / Q000652:urine; D016030:Kidney Transplantation / Q000276:immunology*; D007683:Kidney Tubular Necrosis, Acute / Q000097:blood / Q000652:urine; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019798:Neopterin; D012680:Sensitivity and Specificity
D015850:Interleukin-6; D001708:Biopterins; D019798:Neopterin; D016572:Cyclosporine; D003404:Creatinine