Significance of IL-2, IL-2R, IL-6, and TNF-Alpha as a Diagnostic Test of Acute Rejection After Renal Transplantation

Abstract

ACUTE REJECTION of the graft is a complex process which results in tissue edema, infiltration of inflam- matory cells, thrombosis in the microcirculation due to reaction of immune cells, and, finally, tissue necrosis. After introduction of advanced immunosuppressant including cyclosporin, classic clinical findings are missed frequently, so that the diagnosis of rejection becomes difficult. Graft biopsy makes most definitive diagnosis of rejection, but it is invasive and may cause serious complications. Various efforts have been made for early diagnosis by checking immune cells and its products using molecular techniques. Among them, measurement of cytokines in the blood and graft excretion1–4 is under investigation. In the present report, serum interleukin–2 (IL–2), inter- leukin–2 receptor (IL–2R), interleukin–6 (IL–6), and tu- mor necrosis factor (TNF)–a of renal transplant recipients were serially measured for 1 month after transplantation; the changes in rejection group compared with the non– rejection group, and the differences checked according to the response of the steroid pulse therapy in case of acute rejection.