Abbreviations used in this paper: ET, essential thrombocythemia; DS-sIL-6R, soluble receptor for IL-6 originated from differential splicing; PC-sIL-6R, soluble receptor for IL-6 originated from proteolytic cleavage; ADAM, a disintegrin and metalloproteinase domain; FCS, fetal calf serum; TAPI, TNF- protease inhibitor; PBMC, peripheral blood mononuclear cells.In a previous study, we found increased plasma sIL-6R levels in patients with essential thrombocythemia (ET) that could promote megakaryocytopoyesis through IL-6 binding and further interaction with the signal transducer gp130. Here we have searched for the cell source of sIL-6R within mononuclear cells in these patients and the underlying abnormalities involved in its overproduction.
PATIENTS AND METHODS.Thirty patients with the diagnosis of essential thrombocythemia were studied. sIL-6R levels were measured by ELISA technique in the supernatants of peripheral monocyte and lymphocyte cultures. Expression of membrane anchored IL-6 receptor was determined by flow cytometry. In order to study the mechanism of sIL-6R production, TNF- protease inhibitor (TAPI) was added to specifically block IL-6R shedding. Gene expression of sIL-6R levels were evaluated by RT-PCR.
RESULTS.Monocytes were the main source of sIL-6R. Besides, in ET patients, monocyte sIL-6R release was higher than that of controls, p = 0.0014. Lymphocytes enhanced monocyte sIL-6R production by cell-mediated contact in normal controls, but this cooperation could not be seen in patients. Membrane expression of IL-6R was increased after monocyte adhesion in ET. sIL-6R synthesis was up-regulated in most patients while mRNA was normal.
CONCLUSION.Our results indicate that ET monocytes are responsible for sIL-6R overproduction within mononuclear cells through synthesis up-regulation. In addition, the lack of cooperation of lymphocytes in monocyte sIL-6R production in ET could be due to a monocyte abnormality. The agonistic effect of sIL-6R on IL-6 action could contribute to the exacerbated megakaryocytic growth in ET.