Association of tumour necrosis factor alpha and interleukin 6 levels with cytomegalovirus DNA detection and disease after renal transplantation.
Cytokines such as tumour necrosis factor alpha (TNF-alpha) and interleukin 6 (IL-6) are thought to be important in the pathogenesis of post-transplant cytomegalovirus (CMV) disease. CMV infection increases the production of TNF-alpha and IL-6. Conversely, TNF-alpha switches on the replication of CMV. To study the association of these two cytokines with CMV activity and disease, TNF-alpha and IL-6 levels were assayed in plasma samples taken serially from three groups of renal transplant recipients. Group A (n = 12) had CMV disease and syndrome; Group B (n = 11) had detectable CMV DNA in plasma or peripheral blood leucocytes without disease, i.e., presumed asymptomatic CMV infection, and Group C (n = 11) had no detectable CMV DNA nor disease. The median peak TNF-alpha levels in patients with CMV disease (Group A) were significantly higher than that in Group B or Group C (P < 0.02) whereas the median peak IL-6 levels in group C patients were significantly lower than that in group A (P < 0.04) or group B (P < 0.03). A TNF-alpha level of above 100 pg/ml was significantly associated with CMV disease and high plasma CMV load (> 10,000 copies/ml). IL-6 levels above 15 pg/ml were significantly associated with CMV DNA detection, but not with CMV disease or elevated CMV load. High levels of TNF-alpha or IL-6 were not associated with CMV donor/recipient serostatus, HHV-6 or HHV-7 DNA detection, immunosuppressive regimen or rejection episodes. The role of TNF-alpha in the pathogenesis of CMV disease deserves further investigation.
Tong
C Y
CY
Department of Medical Microbiology, University of Liverpool, Liverpool, United Kingdom. william.tong@gstt.sthames.nhs.uk
Bakran
A
A
Williams
H
H
Cuevas
L E
LE
Peiris
J S
JS
Hart
C A
CA
D000328:Adult; D015331:Cohort Studies; D003587:Cytomegalovirus / Q000302:isolation & purification / Q000502:physiology; D003586:Cytomegalovirus Infections / Q000097:blood / Q000209:etiology* / Q000276:immunology; D004279:DNA, Viral / Q000032:analysis; D015654:Herpesvirus 6, Human / Q000302:isolation & purification; D016199:Herpesvirus 7, Human / Q000302:isolation & purification; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000276:immunology; D018709:Statistics, Nonparametric; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*; D019562:Viral Load; D014775:Virus Activation
D004279:DNA, Viral; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha