title: A fatal cytokine-induced systemic inflammatory response reveals a critical role for NK cells.
abstract: The mechanism of cytokine-induced shock remains poorly understood. The combination of IL-2 and IL-12 has synergistic antitumor activity in vivo, yet has been associated with significant toxicity. We examined the effects of IL-2 plus IL-12 in a murine model and found that the daily, simultaneous administration of IL-2 and IL-12 resulted in shock and 100% mortality within 4 to 12 days depending on the strain employed. Mice treated with IL-2 plus IL-12 exhibited NK cell apoptosis, pulmonary edema, degenerative lesions of the gastrointestinal tract, and elevated serum levels of proinflammatory cytokines and acute phase reactants. The actions of TNF-alpha, IFN-gamma, macrophage-inflammatory protein-1alpha, IL-1, IL-1-converting enzyme, Fas, perforin, inducible nitric oxide synthase, and STAT1 did not contribute to the observed toxicity, nor did B or T cells. However, toxicity and death from treatment with IL-2 plus IL-12 could be completely abrogated by elimination of NK cells. These results suggest that the fatal systemic inflammatory response induced by this cytokine treatment is critically dependent upon NK cells, but does not appear to be mediated by the known effector molecules of this cellular compartment. These data may provide insight into the pathogenesis of cytokine-induced shock in humans.
authors: Department of Surgery, Arthur G. James Comprehensive Cancer Center, Ohio State University, Columbus 43210, USA. carson-1@medctr.osu.edu
authors: W E
authors: WE
authors: Carson
authors: H
authors: H
authors: Yu
authors: J
authors: J
authors: Dierksheide
authors: K
authors: K
authors: Pfeffer
authors: P
authors: P
authors: Bouchard
authors: R
authors: R
authors: Clark
authors: J
authors: J
authors: Durbin
authors: A S
authors: AS
authors: Baldwin
authors: J
authors: J
authors: Peschon
authors: P R
authors: PR
authors: Johnson
authors: G
authors: G
authors: Ku
authors: H
authors: H
authors: Baumann
authors: M A
authors: MA
authors: Caligiuri
mesh_terms: D000818:Animals; D002469:Cell Separation; D016207:Cytokines / Q000096:biosynthesis / Q000097:blood; D004359:Drug Therapy, Combination; D005260:Female; D007371:Interferon-gamma / Q000502:physiology; D007375:Interleukin-1 / Q000502:physiology; D018664:Interleukin-12 / Q000008:administration & dosage / Q000009:adverse effects; D019409:Interleukin-15 / Q000008:administration & dosage / Q000009:adverse effects; D007376:Interleukin-2 / Q000008:administration & dosage / Q000009:adverse effects; D007378:Interleukins / Q000008:administration & dosage / Q000009:adverse effects*; D007694:Killer Cells, Natural / Q000276:immunology*; D008099:Liver / Q000473:pathology; D008168:Lung / Q000473:pathology; D008262:Macrophage Activation; D008264:Macrophages / Q000276:immunology; D051379:Mice; D008807:Mice, Inbred BALB C; D018345:Mice, Knockout; D016513:Mice, SCID; D008822:Mice, Transgenic; D009000:Monocytes / Q000276:immunology; D012772:Shock, Septic / Q000209:etiology* / Q000276:immunology / Q000401:mortality* / Q000473:pathology; D013154:Spleen / Q000473:pathology; D014409:Tumor Necrosis Factor-alpha / Q000502:physiology
chemical_list: D016207:Cytokines; D007375:Interleukin-1; D019409:Interleukin-15; D007376:Interleukin-2; D007378:Interleukins; D014409:Tumor Necrosis Factor-alpha; D018664:Interleukin-12; D007371:Interferon-gamma