Details

Autor(en) / Beteiligte

• Wang, Hsin-Hui
• Lin, Ching-Yuang

Titel

Interleukin-12 and -18 Levels in Peritoneal Dialysate Effluent Correlate With the Outcome of Peritonitis in Patients Undergoing Peritoneal Dialysis: Implications for the Type I/Type II T-Cell Immune Response

Ist Teil von

• American journal of kidney diseases, 2005-08, Vol.46 (2), p.328-338

Ort / Verlag

Orlando, FL: Elsevier Inc

Erscheinungsjahr

2005

Quelle

MEDLINE

Beschreibungen/Notizen

• Background: We previously showed that a positive impact of peritoneal defense response on the outcome of peritoneal dialysis (PD)-related peritonitis is characterized by an increased pattern of peritoneal CD4/CD8 T-cell ratio with a predominant CD4 +-T helper subtype 1 phenotype. To further explore longitudinal changes in peritoneal immunity during PD-related peritonitis, we examined the production of interleukin 12 (IL-12), IL-18, and interferon γ (IFN-γ) in peritoneal dialysate effluent (PDE) and kinetic expression of the transcription factors T box expressed in T cells (T-bet) and guanine adenine thymine adenine (GATA) binding protein 3 (GATA-3) in peritoneal T cells during peritonitis. Correlations between these observations and responses to antibiotics were analyzed. Methods: IL-12, IL-18, and IFN-γ protein and IFN-γ, T-bet, and GATA-3 messenger RNA (mRNA) were measured in PDE during various phases of peritonitis in 40 patients undergoing PD. Patients were divided into 2 groups according to whether they had a rapid versus delayed response to antibiotic treatment. Results: In the early phase of peritonitis, IL-12, IL-18, and IFN-γ levels in PDE were significantly greater in the rapid-response group ( P < 0.05). Changes in peritoneal IL-12 and IL-18 levels preceded changes in IFN-γ levels. The kinetics of IFN-γ, T-bet, and GATA-3 mRNA expression in peritoneal T cells, measured by means of real-time polymerase chain reaction, differed between the 2 groups. In the rapid-response group, IFN-γ and T-bet mRNA expression increased, whereas that of GATA-3 decreased over time. Results were opposite in the delayed-response group, with IFN-γ and T-bet levels decreasing and GATA-3 levels increasing over time. Conclusion: These data suggest that local IL-12 and IL-18 production is part of a protective early immune response to PD-related peritonitis. High IL-12 and IL-18 levels in PDE during the early phase of peritonitis correlated with a predominant type 1 immune response and favorable outcome.