Lissoni P, Barni S, Cattaneo G, Archili C, Perego M, Tancini G
Divisione di Radioterapia Oncologica, Ospedale San Gerardo, Monza, Milano, Italy.
Tumori. 1990 Dec 31;76(6):603-5. doi: 10.1177/030089169007600620.
Increased capillary permeability and severe hypotension represent the two major cardiovascular complications of IL-2 immunotherapy. The mechanisms responsible for IL-2 cardiovascular toxicity are still obscure. Since increased vascular permeability and vasodilatation may be also induced by the cardiac hormone atrial natriuretic peptide (ANP), we have evaluated ANP concentrations in relation to mean arterial pressure in one patient with metastatic renal carcinoma, treated with a 24-h intravenous infusion of IL-2 at a dose of 3 x 10(6) Cetus U/m2/day for 5 days. The results showed that episodes of important hypotension were associated with abnormally high plasma levels of ANP. Owing to its vasodilator activity, exaggerated ANP secretion, perhaps due to an inappropriate cardiac endocrine function in response to hemodynamic changes induced by IL-2, may play a role in hypotension, which occurs during IL-2 immunotherapy for cancer.
毛细血管通透性增加和严重低血压是白细胞介素-2免疫疗法的两大主要心血管并发症。白细胞介素-2心血管毒性的发病机制仍不清楚。由于心脏激素心房利钠肽（ANP）也可能导致血管通透性增加和血管扩张，我们评估了1例转移性肾癌患者在接受为期5天、剂量为3×10⁶Cetus U/m²/天的白细胞介素-2 24小时静脉输注治疗期间，ANP浓度与平均动脉压的关系。结果显示，严重低血压发作与血浆中异常高的ANP水平相关。由于其血管舒张活性，ANP分泌过度（可能是由于对白细胞介素-2引起的血流动力学变化的心脏内分泌功能失调）可能在癌症白细胞介素-2免疫治疗期间发生的低血压中起作用。
