title: Elevated biliary interleukin 5 as an indicator of liver allograft rejection.
abstract: Interleukin 5 (IL-5) is a T cell-derived cytokine that acts as a potent and specific eosinophil differentiation factor in humans. During liver allograft rejection, intragraft IL-5 mRNA and eosinophilia have been observed. The objective of this study was to correlate the levels of IL-5 in bile and serum with eosinophilia and allograft rejection in paediatric liver recipients. IL-5 levels were determined by ELISA (enzyme-linked immunosorbent assay) in bile (n = 85) and serum (n = 106) and obtained prospectively from 15 patients during the first 3 weeks post-transplantation. Biliary and serum IL-5 levels were significantly elevated during allograft rejection compared to IL-5 levels when no rejection was apparent or during infectious complications. The highest IL-5 levels were measured in the bile during the early rejection period (3 days prior to biopsy-proven rejection). Fifteen of 16 rejection episodes were marked by increases in IL-5 as revealed by analysis of sequential samples from individual patients. In all patients with rejection, elevations in serum IL-5 were associated with elevations in peripheral eosinophil counts. These results indicate that IL-5 is produced in the liver and may be a useful and specific marker of allograft rejection. Furthermore, these findings provide further evidence for a pathway of liver allograft rejection mediated by IL-5 activated eosinophils.
authors.affiliation: Department of Pediatrics, California Pacific Medical Center, San Francisco, USA.
authors.forename: T
authors.initials: T
authors.lastname: Lang
authors.forename: S M
authors.initials: SM
authors.lastname: Krams
authors.forename: W
authors.initials: W
authors.lastname: Berquist
authors.forename: K L
authors.initials: KL
authors.lastname: Cox
authors.forename: C O
authors.initials: CO
authors.lastname: Esquivel
authors.forename: O M
authors.initials: OM
authors.lastname: Martinez
mesh_terms: D000293:Adolescent; D001646:Bile / Q000737:chemistry*; D002648:Child; D002675:Child, Preschool; D004802:Eosinophilia / Q000097:blood / Q000209:etiology; D004804:Eosinophils / Q000378:metabolism; D005260:Female; D006084:Graft Rejection; D006801:Humans; D007223:Infant; D015848:Interleukin-5 / Q000032:analysis* / Q000097:blood / Q000276:immunology; D016031:Liver Transplantation; D008297:Male
chemical_list: D015848:Interleukin-5