Jordan S C, Czer L, Toyoda M, Galfayan K, Doan D, Fishbein M, Blanche C, Trento A
Department of Pediatrics, Cedars-Sinai Medical Center/UCLA School of Medicine 90048.
J Heart Lung Transplant. 1993 Mar-Apr;12(2):333-7.
The ability to detect rejection of human cardiac allografts depends on endomyocardial biopsy diagnosis. Because cytokines are known to mediate allograft rejection events, we chose to examine serum levels of specific cytokines and receptors (interleukin-2 [IL-2], IL-2 receptor [IL-2R], and tumor necrosis factor alpha [TNF-alpha]) and to correlate those levels with findings on endomyocardial biopsy. Sequential sera samples from 23 cardiac allograft recipients were examined for the cytokine levels mentioned, and data correlated with findings on endomyocardial biopsy. Briefly, no statistically correlation of serum cytokine or receptor levels with the stage of allograft rejection was found. When sequential serum cytokine levels were determined in patients experiencing humoral and cellular allograft rejection events, the levels of TNF-alpha appeared to correlate well with endomyocardial biopsy findings. IL-2 and IL-2R levels in two patients who never experienced rejection were elevated on occasion, but TNF-alpha levels were always negative. In summary, measurement of serum cytokine (IL-2, IL-2R) levels in cardiac allograft recipients does not appear to correlate with findings on endomyocardial biopsy; however, elevated levels of TNF-alpha appear to predict more severe humoral allograft rejection episodes and may be helpful in this regard.
检测人类心脏同种异体移植排斥反应的能力取决于心内膜活检诊断。由于已知细胞因子介导同种异体移植排斥反应事件，我们选择检测特定细胞因子和受体（白细胞介素-2 [IL-2]、IL-2受体[IL-2R]和肿瘤坏死因子α [TNF-α]）的血清水平，并将这些水平与心内膜活检结果相关联。对23名心脏同种异体移植受者的系列血清样本进行上述细胞因子水平检测，并将数据与心内膜活检结果相关联。简而言之，未发现血清细胞因子或受体水平与同种异体移植排斥反应阶段存在统计学相关性。在经历体液和细胞同种异体移植排斥反应事件的患者中测定系列血清细胞因子水平时，TNF-α水平似乎与心内膜活检结果密切相关。两名从未经历排斥反应的患者的IL-2和IL-2R水平偶尔会升高，但TNF-α水平始终为阴性。总之，心脏同种异体移植受者血清细胞因子（IL-2、IL-2R）水平的测定似乎与心内膜活检结果无关；然而，TNF-α水平升高似乎预示着更严重的体液同种异体移植排斥反应发作，在这方面可能会有所帮助。
