title: Relationship between bone metabolism and plasma cytokine levels in patients at risk of post-transplantation bone disease after bone marrow transplantation.
abstract: Bone marrow transplant recipients may carry an increased risk of bone diseases, involving numerous factors that affect bone mineral metabolism. Interleukin-6 is a potent stimulator of bone resorption in vivo. The soluble fraction of interleukin-6 receptor is reported to trigger osteoclast formation by interleukin-6 in vitro. In a cross-sectional study we measured serum bone alkaline phosphatase concentrations and the urinary excretion of pyridinium cross-links in 21 patients after bone marrow transplantation, and investigated the relationship between these values and those for the plasma levels of interleukin-6 and soluble interleukin-6 receptor. Following bone marrow transplantation female--but not male--patients showed higher serum bone alkaline phosphatase values than age- and sex-adjusted controls (p < 0.05). Both female and male patients were characterized by increased urinary excretion values of pyridinium cross-links (p < 0.05). In contrast to a marked increase of interleukin-6 plasma levels (p < 0.001) no significant difference in the soluble interleukin-6 receptor levels was found between patients and apparently healthy persons (p = 0.838). Multiple regression analysis (taking into account different variables of the immunosuppressive regimen applied) revealed the plasma concentration of interleukin-6 as an independent predictor of the urinary excretion of pyridinium cross-links (p < 0.05). In conclusion, in patients following bone marrow transplantation, these findings indicate (a) an increase of bone formation in female--but not in male--patients possibly reflecting primary ovarian failure and (b) an enhancement of bone resorption possibly mediated by circulating interleukin-6.
authors.affiliation: Institut für Klinische Chemie und Laboratoriumsdiagnostik, Heinrich-Heine-Universität Düsseldorf, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Withold
authors.forename: H H
authors.initials: HH
authors.lastname: Wolf
authors.forename: S
authors.initials: S
authors.lastname: Kollbach
authors.forename: A
authors.initials: A
authors.lastname: Heyll
authors.forename: W
authors.initials: W
authors.lastname: Schneider
authors.forename: H
authors.initials: H
authors.lastname: Reinauer
mesh_terms: D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood; D015703:Antigens, CD / Q000032:analysis*; D001847:Bone Diseases / Q000453:epidemiology / Q000209:etiology*; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D001842:Bone and Bones / Q000378:metabolism*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D011726:Pyridinium Compounds / Q000652:urine; D018123:Receptors, Interleukin / Q000032:analysis*; D019947:Receptors, Interleukin-6; D012044:Regression Analysis; D012307:Risk Factors; D012727:Sex Characteristics; D016896:Treatment Outcome
chemical_list: D015703:Antigens, CD; D007166:Immunosuppressive Agents; D015850:Interleukin-6; D011726:Pyridinium Compounds; D018123:Receptors, Interleukin; D019947:Receptors, Interleukin-6; D000469:Alkaline Phosphatase