McNally C M, Luckhurst E, Penny R
Centre for Immunology, St Vincent's Hospital, Sydney, Australia.
J Heart Lung Transplant. 1991 Sep-Oct;10(5 Pt 1):769-74.
The aim of this study was to predict episodes of rejection or infection in heart transplant recipients by monitoring serum interleukin-2 receptor (IL-2R) levels, rather than by endomyocardial biopsy. The shedding of IL-2R from activated lymphocytes results in increased serum interleukin-2 levels and is probably a result of immune activation occurring in both rejection and infection processes. As a group, heart transplant recipients who had no rejection of infection had significantly increased serum IL-2R levels compared with healthy controls. Patients who had moderate and severe rejection, and infection, had significantly increased serum IL-2R levels compared with levels in patients without rejection or infection. High serum IL-2R levels were seen mainly within the first 3 months after transplantation. Of 15 patients studied, nine had consistent increases in serum IL-2R levels with episodes of rejection or infection. Serum IL-2R levels did not correlate with serum cyclosporine levels. The monitoring of serum IL-2R levels was not a sensitive test of rejection because increases were not seen in all episodes of rejection; increases were seen, however, in all cases of infection. This test lacked specificity as serum IL-2R levels increased during episodes of both rejection and infection. In conclusion, the monitoring of serum IL-2R levels may be a useful way to routinely monitor or screen for possible rejection infection in heart transplant recipients, but this method should not replace endomyocardial biopsy for diagnosing rejection.
本研究的目的是通过监测血清白细胞介素-2受体（IL-2R）水平，而非通过心内膜心肌活检，来预测心脏移植受者的排斥或感染发作。活化淋巴细胞释放IL-2R会导致血清白细胞介素-2水平升高，这可能是排斥和感染过程中发生的免疫激活的结果。总体而言，与健康对照组相比，未发生感染的心脏移植受者血清IL-2R水平显著升高。与未发生排斥或感染的患者相比，发生中度和重度排斥以及感染的患者血清IL-2R水平显著升高。血清IL-2R水平升高主要出现在移植后的前3个月内。在研究的15名患者中，9名患者血清IL-2R水平随排斥或感染发作而持续升高。血清IL-2R水平与血清环孢素水平无关。监测血清IL-2R水平并非检测排斥的敏感方法，因为并非所有排斥发作时该水平都会升高；然而，在所有感染病例中均可见该水平升高。由于在排斥和感染发作期间血清IL-2R水平都会升高，因此该检测缺乏特异性。总之，监测血清IL-2R水平可能是常规监测或筛查心脏移植受者可能发生的排斥感染的一种有用方法，但该方法不应取代心内膜心肌活检来诊断排斥。
