Interleukin-1 and its naturally occurring antagonist in peritoneal dialysis patients.

We have assessed the levels of interleukin-1b (IL-1b) and interleukin-1 receptor antagonist (IL-1RA) in both serum and peritoneal dialysate effluents (PDE) from nineteen continuous ambulatory peritoneal dialysis patients (CAPD) without peritonitis and three CAPD patients with peritonitis. IL-1 beta and IL-1RA were tested using a specific ELISA immuno-assay. Fifteen normal healthy volunteers severed as control. The serum levels of IL-1RA in CAPD patients were significantly increased comparatively to their levels in healthy volunteers (p < 0.001). CAPD patients without peritonitis (stable patients) showed relatively low levels of IL-1RA in peritoneal dialysate effluents (114.4 +/- 85.1 pg/ml). Patients with peritonitis showed very high serum levels of IL-1RA at the onset of acute infection (4710 +/- 50 pg/ml). The levels of IL-1RA in PDE were very high during the onset of bacterial peritonitis (5744 +/- 254 pg/ml). The clinical recovery from peritonitis was characterized by a fall in IL-1RA in both serum and dialysate. Serum levels IL-1 beta showed a different pattern, it was not detectable in stable CAPD patients as well as in normal healthy volunteers. It was detectable only in serum of patients with peritonitis (10 +/- 0.8 pg/ml). Likewise, in most stable patients, IL-1 beta-PDE levels were not detectable, but substantial amounts can be detected in PDE during bacterial infection (80 +/- 15 pg/ml). The increase in serum and PDE levels of IL-1 beta during bacterial infection was very rapid, this cytokine disappeared in serum and PDE, 2 or 3 days before the clinical recovery.(ABSTRACT TRUNCATED AT 250 WORDS)