Synergism of interleukin 1 and interleukin 6 induces serum amyloid A production while depressing fibrinogen: a quantitative analysis.

OBJECTIVE

Production of the serum amyloid A (SAA) proteins in the liver of patients with arthritis can be increased from approximately 1 microgram/ml to > 1000 micrograms/ml, while fibrinogen (Fg) can be increased from 2 to 9 mg/ml. The increases appear to be regulated by mediators similar to those found in inflamed joints, e.g., interleukins 1 and 6 (IL-1 and IL-6, respectively). The sensitivity and dose response of SAA and Fg synthesis by hepatoma cells to IL-1 and IL-6 was investigated to understand the relationship between the inflammatory cytokines produced in inflamed joints and the acute phase protein response in the liver of arthritis patients.

METHODS

SAA and Fg mRNA and protein production in human Hep3B cells stimulated by human monocyte conditioned medium (CM) containing known amounts of IL-1 and IL-6, or stimulated by corresponding concentrations of recombinant IL-1 and IL-6 was analyzed by ELISA and Northern blot hybridization techniques.

RESULTS

Increases in SAA mRNA and protein were dose dependent in the presence of IL-1 and IL-6 at concentrations ranging from 0.1 and 1 ng/ml, respectively, to 10 and 100 ng/ml, respectively. In the presence of IL-1 receptor antagonist (IL-1ra), there was a 75% decrease in SAA production and > 100% increase in Fg production by cells stimulated with CM.

CONCLUSION

Our results demonstrate that the thousand fold dynamic range associated with the acute phase SAA response requires IL-1 acting synergistically with cytokine(s) like IL-6. Optimum conditions for apoSAA production are suboptimal for Fg as indicated by the differential effects of IL-1ra.