Dynamic Changes in Soluble Interleukin-2 Receptor Levels after Lung or Heart-Lung Transplantation

Abstract

Activation of T-lymphocytes is accompanied by the release of interleukin-2 receptors (IL-2R) in a soluble form that can be measured as an index of the activation process. We performed a prospective, blinded study of the dynamic changes in soluble IL-2R levels in serum in 12 patients undergoing lung or heart-lung transplantation. The levels of soluble IL-2R were markedly elevated during episodes of rejection (geometric mean value X divided by SEM = 3,770 X divided by 1.06 versus 411 X divided by 1.08 U/ml for normal controls, p less than 0.0001). Levels of soluble IL-2R were 2,105 X divided by 1.16 U/ml with rejection episodes in single lung recipients versus 5,560 X divided by 1.30 in recipients of two lungs (p = 0.005). Soluble IL-2R levels were 1,468 X divided by 1.05 during episodes of nonbacterial infections, 1,879 X divided by 1.34 with bacterial infections, and 5,056 X divided by 1.08 with sepsis (p less than 0.001 for each category compared to normals). Levels of soluble IL-2R exceeded 6,750 U/ml only with rejection episodes and were greater than 4,100 U/ml either with rejection, clinical sepsis, or overwhelming bacterial infection. We conclude that marked elevations of soluble IL-2R are associated with rejection, intermediate elevations with either rejection or infection, and that low levels of soluble IL-2R exclude rejection.

Elevated interleukin-2 receptor level in patients with active pulmonary tuberculosis and the changes following anti-tuberculosis chemotherapy

“…In patients with bacterial infections the sIL-2R levels rapidly come down with antibiotic treatment [21], and in patients with asthma the sIL-2R levels decline with steroid treatment [9]. Therefore, the prolonged elevation of sIL-2R in patients with pulmonary TB is unlikely to be due to long half-life of sIL-2R.…”

Serum Levels of the Soluble lnterleukin-2 Receptor Are Dependent on the Kidney Function

“…Increased serum concentrations of S-IL-2R have been observed in autoimmune diseases [6,7]. S-IL-2R is also used for monitoring graft rejection in the kidney [2,11], heart [12], lung [12] and liver [13] transplantation. Measurements of S-IL-2R are also valu able in a variety of lymphoproliferative and hematologic malignancies [ 13,14], Furthermore, increased levels of S-IL-2R have been found in patients with chronic renal fail ure [15,16].…”

Serum Soluble Interleukin 2 Receptor Levels in Erythrodermic Cutaneous T-Cell Lymphoma Correlate With Response to Photopheresis-Based Treatment

“…In addition, the presence of markedly increased3, 9,8,23 or progressively increasing levels may be a poor prognostic sign.1218 Miscellaneous other conditions also can be as¬ sociated with higher than normal serum SIL2R. 24,25 The pathophysiologic importance of circulating SIL2R is not yet well defined. The SIL2R-modified alpha-chain homodimer6 structure is distinct from those of the cell surface high-or intermediate-affinity IL2R heterodimers.4'5 However, SIL2R does maintain low affinity interleukin-2 binding capacity.26 In the context of T-cell clonal expansion, SIL2R may be produced mainly by ma¬ lignant cells.…”