Urinary cytokines for assessing inflammation in HIV-associated wasting.
The relationship between cytokines and HIV-related weight loss has not been well established. Unlike most cytokines that are secreted in a paracrine manner, IL-6, sTNFR-II, and IL-1ra are readily detected in the systemic circulation and serve as markers of the inflammatory response. Twenty-four-hour urine concentrations of these proteins are believed to provide an integrative assessment of their systemic levels over the preceding hours. We sought to determine whether spot measurements of IL-6, sTNFR-II, and IL-1ra could be related to subsequent 24 h concentrations and prior weight loss. Eighteen subjects with severe wasting (average BMI=18+/-3 kg/m2with 19+/-13 kg of weight loss) and six HIV-negative healthy subjects were tested. Compared to values in controls, 24-h urinary concentrations of the three proteins adjusted for creatinine excreted were elevated in 44%, 89%, and 72% of patients, respectively. Twenty-four-hour concentrations were highly correlated with the spot concentrations (r=0.80, 0.87, 0.84, respectively, P<0.001). IL-1ra concentrations (24 h and spot) were correlated with weight loss in the previous 6 months, lifetime rate of weight loss and the 6 month rate of weight loss (spot: r=0.66, 0.73, 0.68, respectively, P< or =0.001). These data suggest that spot urinary collections can be used to estimate 24 h excretion rates. This strategy may be useful in assessing the inflammatory response in HIV-associated wasting.
Division of Infectious Diseases/Department of Medicine, University of Southern California School of Medicine, Los Angeles, California 90033, USA.
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D000328:Adult; D015703:Antigens, CD / Q000652:urine*; D001835:Body Weight; D015704:CD4 Antigens / Q000097:blood; D016022:Case-Control Studies; D003404:Creatinine / Q000652:urine; D016207:Cytokines / Q000652:urine*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019247:HIV Wasting Syndrome / Q000652:urine*; D006801:Humans; D007249:Inflammation; D053590:Interleukin 1 Receptor Antagonist Protein; D015850:Interleukin-6 / Q000652:urine*; D008297:Male; D008875:Middle Aged; D018124:Receptors, Tumor Necrosis Factor; D047889:Receptors, Tumor Necrosis Factor, Type II; D012795:Sialoglycoproteins / Q000652:urine*; D013997:Time Factors
D015703:Antigens, CD; D015704:CD4 Antigens; D016207:Cytokines; C507763:IL1RN protein, human; D053590:Interleukin 1 Receptor Antagonist Protein; D015850:Interleukin-6; D018124:Receptors, Tumor Necrosis Factor; D047889:Receptors, Tumor Necrosis Factor, Type II; D012795:Sialoglycoproteins; D003404:Creatinine