title: Involvement of interleukin-18 in patients on maintenance haemodialysis.
abstract: Maintenance dialysis induces a clinical state of immunodeficiency. The pathway of circulating T cells from haemodialyzed patients is changed and characterized by an increase of Th1 cells. The unbalanced T helper differentiation derives from an altered regulation of interleukin-12 (IL-12), which represents an important inducer of Th1. IL-18 is a pro-inflammatory cytokine expressed by a variety of cell types that is structurally related to the Th1 family and shares biological properties with IL-12 as the promotion of Th1 responses. To explain the involvement of IL-18 in the typical disorders of dialysis, we analyzed IL-18 serum levels in a group of haemodialyzed patients. We enrolled 16 patients on chronic haemodialysis (HD) treatment for end-stage renal failure and 16 healthy volunteers as the control group. IL-18 levels were assessed by immunoenzymatic methods (detection limit was <12.5 pg/ml). HD patients strongly showed higher IL-18 serum levels compared to healthy donors (508.47 +/- 314.39 vs. 193.44 +/- 56.33 pg/ml, p < 0.005). Moreover, IL-18 levels in HD directly correlated to dialytic age (Rho = 0.544, p = 0.0419) and indirectly to Kt/V (Rho = 0.703, p = 0.0086). Our data represent the first evidence of the relation between IL-18 serum levels and HD. In the light of our results, we think that the unbalanced T helper differentiation may depend, at least in part, on an abnormality in the IL-18 production.
authors.affiliation: Division and School of Allergy and Clinical Immunology, Department of Human Pathology, University of Messina Medical School, University Hospital 'G. Martino', Messina, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Gangemi
authors.forename: A
authors.initials: A
authors.lastname: Mallamace
authors.forename: P L
authors.initials: PL
authors.lastname: Minciullo
authors.forename: D
authors.initials: D
authors.lastname: Santoro
authors.forename: R A
authors.initials: RA
authors.lastname: Merendino
authors.forename: V
authors.initials: V
authors.lastname: Savica
authors.forename: G
authors.initials: G
authors.lastname: Bellinghieri
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D020382:Interleukin-18 / Q000096:biosynthesis / Q000097:blood*; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D006377:T-Lymphocytes, Helper-Inducer / Q000276:immunology
chemical_list: D020382:Interleukin-18