Schwaighofer H, Oberhuber G, Hebart H, Einsele H, Herold M, Nachbaur D, Eibl B, Tilg H, Kropshofer G, Ferrara J L, Niederwieser D
Division of Clinical Immunobiology, Department of Internal Medicine, University of Innsbruck, Austria.
Transplantation. 1997 Jan 15;63(1):52-6. doi: 10.1097/00007890-199701150-00010.
In order to understand in more detail the role of endogenous interleukin 1 receptor antagonist (IL-1ra) during bone marrow transplantation, IL-1ra serum levels of 28 patients undergoing allogeneic (n=25) or autologous (n=3) bone marrow transplantation were measured with a commercially available ELISA. In addition, the impact of intravenous immunoglobulin (IVIG) was evaluated by analyzing IL-1ra serum levels before and 2, 5, and 24 hr after IVIG infusion. IL-1ra measurements revealed a nadir of circulating IL-1ra levels 3-5 days after bone marrow transplantation, with an increase during conditioning and hematological reconstitution. Circulating IL-1ra levels were significantly increased in patients with cytomegalovirus (CMV) disease, CMV reactivation, graft-versus-host disease (GVHD), or fever of unknown origin, when compared with time-matched controls without complications. Highest levels were observed in patients with CMV disease (1922+/-388 pg/ml), followed by patients with CMV reactivation (1575+/-435 pg/ml) and GVHD (1178+/-317 pg/ml). The magnitude of IL-1ra increase in GVHD was related to disease severity. Patients with grade III-IV GVHD developed higher IL-1ra levels than did patients with grade I-II GVHD. Lower but still significantly elevated IL-1ra levels were observed during fever of unknown origin (384+/-87 pg/ml). An increase of IL-1ra serum levels followed the administration of IVIG before transplantation and after hematopoietic reconstitution, but not during aplasia, pointing to the important role of hematopoietic cells in the production of IL-1ra. In conclusion, we show that IL-1ra release is related to conditioning regimen, hematopoietic reconstitution, complications of infectious and alloimmune etiology after bone marrow transplantation, and exogenously administered IVIG.
为了更详细地了解内源性白细胞介素1受体拮抗剂（IL-1ra）在骨髓移植过程中的作用，使用市售酶联免疫吸附测定法（ELISA）检测了28例接受异基因（n = 25）或自体（n = 3）骨髓移植患者的IL-1ra血清水平。此外，通过分析静脉注射免疫球蛋白（IVIG）输注前以及输注后2、5和24小时的IL-1ra血清水平，评估了IVIG的影响。IL-1ra检测显示，骨髓移植后3 - 5天循环IL-1ra水平出现最低点，在预处理和血液学重建期间升高。与无并发症的时间匹配对照组相比，巨细胞病毒（CMV）疾病、CMV再激活、移植物抗宿主病（GVHD）或不明原因发热患者的循环IL-1ra水平显著升高。CMV疾病患者的IL-1ra水平最高（1922±388 pg/ml），其次是CMV再激活患者（1575±435 pg/ml）和GVHD患者（1178±317 pg/ml）。GVHD中IL-1ra升高的幅度与疾病严重程度相关。III - IV级GVHD患者的IL-1ra水平高于I - II级GVHD患者。在不明原因发热期间观察到IL-1ra水平较低但仍显著升高（384±87 pg/ml）。在移植前和造血重建后给予IVIG后，IL-1ra血清水平升高，但在再生障碍期间未升高，这表明造血细胞在IL-1ra产生中起重要作用。总之，我们表明IL-1ra释放与预处理方案、造血重建、骨髓移植后感染和同种免疫病因的并发症以及外源性给予的IVIG有关。
