Sobotka P A, McMannis J, Fisher R I, Stein D G, Thomas J X
Department of Medicine, Loyola University of Chicago, Stritch School ofMedicine, Maywood, Illinois 60153.
J Clin Invest. 1990 Sep;86(3):845-50. doi: 10.1172/JCI114783.
Adoptive immunotherapy with IL 2 is associated with severe cardiovascular toxicities including peripheral and pulmonary edema, hypotension decreased systemic vascular resistance, increased heart rate, and an increased cardiac index. The purpose of this investigation was to determine whether IL 2 alone or in combination with lymphokine-activated killer cells (LAK) cells depress cardiac function using the isolated, perfused, working rat heart preparation. Male Sprague-Dawley rats (250-350 g) were anesthetized and the hearts were removed and placed on the perfusion apparatus. Hearts were perfused with oxygenated Krebs-Henseleit buffer (KHB), or oxygenated KHB containing IL 2 alone, IL 2-Media (cell culture media supplemented with 1,500 U IL 2/ml), LYMPH (cell culture media from cultured mononuclear cells from healthy volunteers), or LAK (cell culture media from cultured lymphocytes harvested from patients receiving IL 2/LAK in the presence of 1,500 U/ml IL 2). The cells were removed before perfusion (n = 9). Cardiac output and coronary flow were measured at 20-min intervals with preload constant (afterload varied or afterload constant (preload varied). The results indicate a significant depression in cardiac function in hearts treated with LAK. This depression was evident at 20 min and was more pronounced at 60 min. Washout of the KHB plus LAK reversed this depression. Thus, IL 2-stimulated/cultured human mononuclear cells produce a soluble factor that produces a reversible severe depression of cardiac function.
采用白细胞介素-2进行过继性免疫治疗与严重的心血管毒性相关,包括外周和肺水肿、低血压、体循环血管阻力降低、心率加快以及心脏指数增加。本研究的目的是使用离体、灌注、工作的大鼠心脏标本,确定单独使用白细胞介素-2或与淋巴因子激活的杀伤细胞(LAK细胞)联合使用是否会降低心脏功能。将雄性斯普拉格-道利大鼠(250 - 350克)麻醉后取出心脏,置于灌注装置上。心脏用含氧的克雷布斯-亨塞尔特缓冲液(KHB)灌注,或用单独含白细胞介素-2的含氧KHB、白细胞介素-2培养基(补充有1500 U白细胞介素-2/毫升的细胞培养基)、LYMPH(来自健康志愿者培养的单核细胞的细胞培养基)或LAK(来自接受白细胞介素-2/LAK治疗的患者且存在1500 U/毫升白细胞介素-2时培养的淋巴细胞的细胞培养基)灌注。灌注前去除细胞(n = 9)。在预负荷恒定(后负荷变化)或后负荷恒定(预负荷变化)的情况下,每隔20分钟测量心输出量和冠状动脉血流量。结果表明,用LAK处理的心脏心脏功能有显著降低。这种降低在20分钟时明显,在60分钟时更显著。用KHB加LAK冲洗可逆转这种降低。因此,白细胞介素-2刺激/培养的人单核细胞产生一种可溶性因子,该因子会导致心脏功能出现可逆性严重降低。