Screening for prostate cancer

In an attempt to detect prostate cancer when the tumor is still confined to the prostate, a screening program was established. We studied the efficacy of digital rectal examination (DRE) and serum prostate-specific antigen (PSA) in the early detection of prostate cancer. One thousand men aged 50-75 years underwent DRE and serum PSA determination. Transrectal ultrasound-guided biopsies were obtained in each case of a suspicious DRE. Six systematic biopsies were performed if the PSA level was > 10 ng/ml, even if DRE and transrectal ultrasonography revealed no areas suspicious of cancer. A suspicious DRE was noted in 11.5% of the subjects; 16% had elevated levels of serum PSA (> 4 ng/ml) and 3.9% had serum PSA > 10 ng/ml. Biopsies were obtained from 90 patients, of which 31 were positive for prostate cancer. The cancer detection rate was 2.2% for DRE, 2.0% for PSA > 10 ng/ml, and 3.1% for the two methods combined. Clinical staging revealed that in 29 of the 31 patients with prostate cancer, the tumor was confined to the prostate: Stage A in 9 cases and stage B in 20 cases. Only two patients had clinically advanced cancer, and 22 patients underwent radical prostatectomy. Pathological examination disclosed biologically significant tumors in 91% of the cases in terms of tumor volume and grade. Although there is little evidence that screening will result in the reduction of the disease-specific mortality rate, early detection of prostate cancer by DRE, serum PSA, and transrectal ultrasound should be encouraged.

Changes in interleukin-1 beta and soluble interleukin-2 receptor levels in CSF and serum of schizophrenic patients

Some evidence points towards a possible autoimmune role in the aetiology of schizophrenia. Experimental findings provide contradictory results regarding abnormalities in cytokine production in this disorder. In the present study we tested the production of cytokines in CSF and serum in 16 schizophrenic patients and 10 healthy controls (tumor necrosis factor alpha - TNF alpha; interleukins IL-1 beta, IL-2, IL-6, soluble IL-2 receptor). Cytokine levels were evaluated by radioactively-labeled antibodies (IL-1 beta, IL-2, IL-6), by enzyme-linked immunoassay (TNF) and by a sandwich enzyme immunoassay (soluble IL-2 receptor). No significant differences were found in either CSF fluid or serum levels of TNF and IL-2 or IL-6. Interleukin-1 beta was significantly decreased in patients' CSF and serum as compared to controls. Soluble interleukin-2 receptor levels were decreased in CSF of patients, but highly increased in their serum in comparison with controls. Changes in various cytokine levels in CSF fluid and serum of schizophrenic patients probably reflect interrelated process of growth, degeneration or neuroimmunological abnormalities, which may all play a role in the pathophysiology of schizophrenia. The present study supports evidence for change in immune activation, probably of peripheral origin, in schizophrenic patients.

Cytokine and growth factor gene expression by bone marrow stroma of mice with damaged hematopoiesis and during regeneration

A study of gene expression of GM-CSF, IL-3, c-kit ligand, and IL-1 by bone marrow stromal cells of mice who were treated with an LD50 cytosine arabinoside (Ara-C) dose was carried out. It was shown previously that this dose causes extensive hematopoietic damage which is followed by regeneration in surviving mice. Using PCR, we demonstrated GM-CSF and IL-1 expression by adherent cells taken from marrow fibroblast layers following Ara-C-induced hematopoietic damage and during marrow regeneration, while expression in control layers was not detected. The IL-3 gene was not expressed either by layers of Ara-C-treated mice or by controls, probably due to the absence of T-lymphocytes in 2-4 week old cultures. The c-kit ligand gene was expressed by layers during marrow regeneration and by control layers, but was absent during the stage of hematopoietic damage. In parallel, in vitro cytokine production was evaluated. While IL-3 and GM-CSF were not present in the conditioned medium of marrow fibroblast layers either from Ara-C-treated mice or controls, IL-1 was found in low concentrations in cultures from Ara-C-treated animals. We conclude that GM-CSF, c-kit ligand and IL-1 have important roles in sustaining marrow regeneration following extensive damage. The role of IL-3 in marrow regeneration cannot be assessed in fibroblast layers of 2-4 week incubation where T-lymphocytes are generally absent.

The effect of human myelomonocytic leukemic cell line (M20) derived IL-1 inhibitor on human erythroid cell development

The effect of an inhibitor of IL-1, purified from a human myelomonocytic cell line (M20) on the development of human erythroid cell development was studied. The inhibitor, is a protein of 52 kD molecular weight that is distinct immunologically and functionally from other reported IL-1 inhibitors. The experiments were performed in a two-phase culture system that allows separation of the erythroid cell development into an erythropoietin (EPO)-independent phase, where early erythroid-committed BFUe proliferate and differentiate into the more mature progenitors, CFUe, and EPO-dependent phase, where CFUe further proliferate and mature into hemoglobin-containing orthochromatic normoblasts. The results indicated that in both developmental stages the M20-derived inhibitor reversibly blocked cell proliferation without interfering with cell differentiation.

Sequential manifestation of different forms of early-onset periodontitis. A case report

Pathogenic bacteria constitute the primary extrinsic agent in the etiology of early onset periodontitis. However, the risk of developing periodontal disease is not equal for all individuals, suggesting host factors are involved in determining an individual's disease susceptibility. In this report, a case of an otherwise healthy female, who exhibited prepubertal periodontitis (PPP) at age 10, juvenile periodontitis (JP) at age 13, and rapidly progressive periodontitis (RPP) at age 29 years, is presented. Microbial, immunological, and genetic features of the case are presented. PPP, JP, and RPP are considered distinct disease entities, albeit with similar pathology and pathogenesis, yet all were manifest sequentially in the same individual. This report presents the idea that certain individuals are predisposed to early-onset periodontal diseases and the early identification of risk factors is important in the management of these individuals.

High concentration of soluble interleukin-2 receptors in ejaculate with low sperm motility

The various cytokines are involved in infection and immunological reactions and thus may be involved in impairment of sperm function. The present study determined the concentrations of interleukin-1, interleukin-6 and soluble interleukin-2 receptors in ejaculates of normal donors and patients suffering from pure asthenozoospermia and patients suffering from oligoteratoasthenozoospermia. Ejaculates of patients attending the fertility clinic in Hadassah Mount Scopus Hospital, Israel, were evaluated. The patients were divided into three groups: (i) controls (n = 20), (ii) pure asthenozoospermia (n = 30), (iii) oligoteratoasthenozoospermia (n = 36). Significantly higher concentrations of soluble interleukin-2 receptors were found in the ejaculates of patients with pure asthenozoospermia 2243.1 +/- 473.6 mu/ml (mean +/- SE) as compared with controls 673.5 +/- 281.3 mu/ml (P < 0.05) and oligoteratoasthenozoospermic patients 1012.3 +/- 206.9 mu/ml (P < 0.05). Interleukin-1 and interleukin-6 concentrations were comparable in all groups studied. Our results show that human ejaculates contain interleukin-1, interleukin-6 and soluble interleukin-2 receptors. High concentrations of soluble interleukin-2 receptors in the ejaculates of asthenozoospermic patients may be related to either infectious or immunological processes.

Differential responses of fetal, neonatal, and adult myelopoietic progenitors to interferon and tumor necrosis factor

Human fetal liver (FL) and neonatal cord blood (CB) granulocyte-monocyte colony-forming progenitor cells (GM-CFC) are unique in their physiological environment and in certain proliferative and differentiative capacities. Tumor necrosis factor (TNF) and interferon (IFN) may inhibit or stimulate the growth of human bone marrow GM-CFC in vitro. The effects of recombinant human (rh) TNF-alpha, rhIFN-alpha, and rhIFN-tau on recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF)-stimulated clonogenic cultures of day 7 GM-CFC from FL and umbilical CB were compared with rhGM-CSF-stimulated GM-CFC from normal human bone marrow (BM). We demonstrate that, in comparison to BM progenitor cells, GM-CFC from both FL and CB were highly resistant to growth inhibition by all three cytokines. Furthermore, clonogenic growth of progenitors from FL and CB was markedly potentiated by IFN-tau in GM-CSF-stimulated cultures and was stimulated by IFN-tau in the absence of GM-CSF. Depletion of potential accessory cells resulted in a marked stimulatory response of CB cells to TNF-alpha, in the presence of GM-CSF, while it did not alter the responses to IFN. The stimulatory effects of IFN-tau and TNF-alpha may be indirectly mediated, at least in part, through induction of increased GM-CSF production and increased GM-CSF receptor expression by fetal cells. Divergent responses of myelopoietic cells, derived from various hematopoietic compartments, to regulatory actions of cytokines may provide a basis for further understanding the role of the environment in maturation and differentiation of granulocytes and monocytes.

The secretion of PGE2, IL-1 beta, IL-6, and TNF alpha by adherent mononuclear cells from early onset periodontitis patients

The secretion of prostaglandin E2 (PGE2), tumor necrosis factor alpha (TNF alpha), interleukin 1 beta (IL-1 beta), and interleukin 6 (IL-6) by adherent mononuclear cells (AMNC) from 28 patients with early-onset periodontitis was studied. The early onset-periodontitis patients consisted of 12 patients with localized juvenile periodontitis (LJP) and 16 patients with severe generalized periodontitis (SGP). The AMNC responses to different concentrations of lipopolysaccharide (LPS) (E. coli) were determined in these 28 patients and compared to 14 healthy controls. Mediator levels in the supernatant were measured using radioimmunoassays for PGE2, IL-1 beta, and IL-6 determination and an enzyme linked immunosorbent assay for TNF alpha levels. The mean age of the patients was 19.9 years for the LJP group, 30.4 years for SGP, and 28.0 years for the controls. The mean number of teeth per patient with attachment loss of > 6 mm was 4.75 in the LJP patients and 17.3 in the SGP group. In the absence of LPS, LJP AMNC secreted significantly more PGE2 than unstimulated control or SGP AMNC, while similar baseline amounts of IL-1 beta, IL-6, and TNF alpha were secreted by AMNC from the 3 patient groups. LPS stimulation resulted in the dose-dependent secretion of significantly higher levels of PGE2 by LJP AMNC compared to SGP AMNC which in turn secreted significantly more than controls. TNF alpha secretion by LJP monocytes was significantly greater than the SGP and the control groups while IL-1 beta secretion by the SGP AMNC was depressed compared to the other two patient groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Interleukin-1 favours the in vitro development of type 2 T helper (Th2) human T-cell clones

The effects exerted by interleukin-1 (IL1) on the growth and differentiation of human Th1 and Th2 cells were examined. Neither IL1 nor the IL1 receptor antagonist (IL1ra) had detectable activity toward the antigen- or anti-CD3 antibody-induced proliferative response of already established type 1 T helper (Th1) or type 2 T helper (Th2) clones. Moreover, neither exogenous IL1 addiction to, nor neutralization of, endogenously produced IL1 in bulk cultures before cloning changed the Th1-like cytokine profile of PPD-specific T-cell lines. Likewise, IL1 addition in bulk culture before cloning did not significantly affect the Th2-like cytokine profile of Der.p.I-specific T-cell lines (Dermatophagoides pteronyssinus group I). However, Der.p.I-specific T-cell lines, derived in the presence of anti-IL1 Ab, IL1ra or the M-20 IL1 inhibitor, exhibited the reduced ability to produce IL4 and an increased ability to produce interferon gamma (IFN gamma). More importantly, Der.p.I-specific T-cell lines derived in the presence of IL1ra developed into Der.p.I-specific CD4+ T-cell clones showing a Th0/Th1-like, instead of a Th0/Th2-like, cytokine profile. These data suggest that IL1 is not required for the growth of already established human Th1 or Th2 CD4+ T-cell clones and has no regulatory effects on the in vitro development of Th1-like cells, but it plays a critical role in the development of Th2-like cells.

Treatment of chronic myelogenous leukemia with recombinant human interleukin-2 and interferon-alpha 2a

The safety, tolerance, and clinical effects of combined therapy with recombinant interferon-alpha (IFN-alpha) and interleukin-2 (rIL-2) administered subcutaneously for 2 courses of 4 weeks each, with 4 weeks interval between courses, given as outpatient therapy have been assessed in 10 patients with Philadelphia chromosome (Ph1)-positive chronic myelogenous leukemia (CML). All patients were previously treated with conventional chemotherapy and 3 failed to respond to IFN-alpha administered prior to our study. Median duration of disease from diagnosis was 36 months. Seven patients were in first chronic phase and the other 3 were in blast crisis, second chronic phase, and relapse post-bone marrow transplantation (BMT), respectively. Hematological response (median follow-up 16 months) was observed in 9 patients, with a decline in number of white blood cells and platelets. Elimination of Ph1 was observed in the patient who relapsed post-BMT with complete elimination bcr/abl RNA by polymerase chain reaction. Rebound lymphocytosis and eosinophilia were observed in most of the patients. Toxicity was acceptable. The main adverse effects were fever, chills, fatigue, anorexia, nausea, and vomiting. The side effects were reversible and no interruption of treatment was required. There was no treatment-related hospitalization or deaths. These data suggest that simultaneous subcutaneous IFN-alpha and rIL-2 home therapy is feasible, reasonably well tolerated, and potentially beneficial in CML patients. These observations may have important implications for the treatment of minimal residual disease following allogeneic and autologous marrow transplantation.

Soluble interleukin-2 receptor levels in cytomegalovirus disease and graft versus host disease after T-lymphocyte depleted bone marrow transplantation for hematological neoplasias

In recent years, the soluble Interleukin-2 Receptor (sIL-2R) has gained recognition as a valuable marker of in vivo activated immune functions in a variety of diseases. We studied sIL-2R levels in patients with cytomegalovirus (CMV) disease, and/or graft versus host disease (GVHD) following bone marrow transplantation (BMT). Our study included 36 patients after T-cell depleted allogenic BMT and 11 healthy controls. Mean sIL-2R serum levels were significantly higher after BMT than before (1273 u/ml vs. 629 u/ml, respectively, p < 0.007). In the patients who developed CMV disease, with or without GVHD, mean sIL-2R levels increased significantly (2866 u/ml p < 0.004); there was a drop after recovery (1949 u/ml), but not a return to pre-CMV onset levels. Similar elevated sIL-2R levels were found in patients during CMV disease only, GVHD only, or both. In patients who developed GVHD, sIL-2R levels were positively correlated with the severity of GVHD (Pearson's correlation coefficient .8322, p < 0.003). We conclude that sIL-2R may serve as a valuable nonspecific marker for the presence of CMV disease and severity of GVHD following T-lymphocyte depleted BMT.

In vivo anti-inflammatory effects of the M20 IL-1 inhibitor: II. Effects on serum reactants

We have previously described an IL-1 Inhibitor derived from the M20 myelomoncytic cell line. This line also secretes several molecules of IL-1. We have shown that this factor is specific to IL-1 in vitro, as well as in vivo. In vitro IL-1 induced proliferative responses of mouse thymocytes, human T cells and fibroblasts and IL-1 stimulated PGE2 secretion from fibroblasts, were all inhibited by the M20 IL-1 Inhibitor. In vivo, the IL-1 Inhibitor reduced parameters of acute inflammation such as fever, leukocytosis and local inflammation. This study describes additional effects of the M20 IL-1 Inhibitor on inflammatory serum reactants. Levels of corticosterone and fibrinogen were increased by injection of IL-1, and decreased by the IL-1 Inhibitor. IL-1 reduced zinc and iron plasma levels and elevated copper plasma levels. The M20 IL-1 Inhibitor reversed these changes in a dose dependent manner. Similar effects produced by IL-6 and TNF were unaffected by the M20 IL-1 Inhibitor. Our results indicate that the M20 IL-1 Inhibitor acts specifically on IL-1 induced responses in vivo. Therefore we conclude that this IL-1 Inhibitor has a great potential as an anti-inflammatory agent.

In vivo anti inflammatory effects of the M20 IL-1 inhibitor: I. Effects on acute inflammatory parameters

Previous studies have described an IL-1 Inhibitor produced by a myelomonocytic line developed in our laboratory (Eur J Immunol 1986; 16: 1449). This IL-1 Inhibitor was secreted by the M20 line constitutively in addition to IL-1, from which it could be separated. We have recently shown that the M20 IL-1 Inhibitor is distinct from the IL-1ra. In vitro this factor inhibited IL-1 induced proliferative responses as well as PGE2 secretion by IL-1 induced fibroblasts. We also showed for the first time (Lymphokine Research 1988; 7(3): 268) that an IL-1 inhibitor can reduce IL-1 induced inflammatory effects. This study describes the specific effect of the M20 IL-1 Inhibitor on IL-1 induced parameters of inflammation: fever, leukocytosis and local foot pad swelling or lymph node enlargement. Purified preparations of the IL-1 Inhibitor, when injected together with IL-1, or before the IL-1, reduced fever, leukocytosis, foot pad swelling and lymph node enlargement caused by IL-1. Similar responses were obtained by injection of IL-6 or TNF, but were unaffected by the IL-1 Inhibitor, when injected together. These results indicate that the M20 IL-1 Inhibitor acts specifically on IL-1 induced responses in vivo. The potential importance of this factor as an anti-inflammatory and immune regulatory factor, is supported by the findings of this study.

Rapid fluorometric quantification of monocyte attachment in tissue culture wells

A simple fluorometric assay that permits rapid quantification of attachment of monocytes or macrophages in tissue culture wells is described. Using 4,6-diamidino-2-phenylindole (DAPI) as a specific fluorochrome marker for DNA, we observed a dose-dependent increase with strong linear correlation in fluorescent emission over a broad range of DNA concentrations. Measurements of the DNA content of the human monocytic cell line THP-1 demonstrated a linear correlation between fluorescence intensity and cell number from 5 x 10(4) to 1 x 10(6) cells, with an estimated average DNA content of 7.5 pg DNA per cell. While untreated THP-1 cells were not detectably adherent, PMA induction for 24 h results in 57-76% adherence to plastic surface. This method was found to be useful for measuring the number of peripheral blood monocytes separated from lymphocytes by attachment. 16 subjects were sampled and the standard deviation of each individual did not exceed 10%. The number of attached cells was between 10-16% of the total mononuclear cells. Fluorescence measurement of DNA with DAPI permits rapid and accurate determination of cell numbers and appears useful in the quantification of adherent populations such as myelocytic cells and cell lines.

Episodic angioedema with eosinophilia: a case associated with T cell activation and cytokine production

Episodic angioedema with eosinophilia is a rare syndrome, characterized by periodic attacks of fever, myalgia, angioedema, and oliguria, associated with an increased eosinophil count. The pathogenesis of this disorder is incompletely understood. We describe an additional patient with episodic angioedema and eosinophilia, and review the literature regarding the clinical features and treatment of this disease. Previous hypotheses regarding disease mechanisms are discussed. In our patient, we found high basal levels of interleukin-1 (IL-1) and soluble interleukin-2 receptor (sIL-2R), with further increases in levels of both mediators during attacks. We suggest that IL-1 and T cell activation may play a role in the pathophysiology of episodic angioedema with eosinophilia.

Serum levels of interleukin-2 receptor in ocular Behçet's disease

Serum interleukin-2 receptor levels were evaluated in 69 patients who had chronic bilateral uveitis and in 22 control subjects. Fifty-one of the 69 patients with uveitis had the ocular type of Behçet's disease and 18 had pars planitis (intermediate uveitis). The mean serum interleukin-2 receptor level was 412.6 +/- 94.6 U/ml for the control group, 465.0 +/- 96.6 U/ml for the patients with intermediate uveitis, and 810.9 +/- 369.3 U/ml for those with ocular Behçet's disease. The serum interleukin-2 receptor levels of patients with ocular Behçet's disease were significantly different from the levels of both the control and the intermediate uveitis groups (P < .001). The differences in serum levels of patients with intermediate uveitis and the levels of the control subjects were not statistically significant. Treatment of patients with ocular Behçet's disease for four to six weeks with either cyclosporine, methylprednisolone, or a combination of both, decreased the intraocular inflammation in nearly all cases. The influence of treatment on the level of serum interleukin-2 receptor, however, was variable.

The M20 IL-1 inhibitor. II. Biological characterization

Interleukin-1 (IL-1) is an important mediator in inflammation and immunological processes. The findings of native IL-1 inhibitors suggest a negative feedback mechanism to down-regulate IL-1 mediated acute inflammation. IL-1 inhibitors were also found elevated in disease states associated with high IL-1 levels. We have previously described one such IL-1 inhibitor derived from the human M20 myelomonocytic cell line. In this paper we present several biological and biochemical characteristics of the M20 IL-1 inhibitor. Various in vitro activities of the inhibitor are described and its IL-1 specificity in these assays is demonstrated. Purification of the inhibitor was performed by DEAE-high performance liquid chromatography, isoelectric focusing, gel filtration and dye ligand chromatography column. This protein factor has a MW of 52 +/- 4 kDa and a pI of 4.15 +/- 0.1. The inhibitor has no cross-reactivity against a panel of known cytokines (IL-1 alpha, IL-1 beta, IL-2, sIL-2R, IL-6, tumor necrosis factor (TNF), interferon-gamma (IFN-gamma)) and is distinct from the IL-1 receptor antagonist (IL-1ra). The purified IL-1 inhibitor was destroyed by trypsin, 2-mercaptoethanol, sodium dodecyl sulfate and extremes in pH and in temperature. Only IL-1 induced (but not the IL-2, IL-6 or TNF induced) thymocyte proliferation and PGE2 production by fibroblasts were inhibited by the inhibitor, thus showing specificity to IL-1 in these assays.

The M20 IL-1 inhibitor. I. Purification by preparative isoelectric focusing in free solution

An interleukin-1 (IL-1) inhibitor produced by the M20 myelomonocytic cell line has been shown to be active in various in vitro and in vivo IL-1 induced parameters. This inhibitor has been purified from the conditioned medium by gel filtration through a Sephacryl S-300 column or dye ligand chromatography on Affi-Gel blue column, followed by isoelectric focusing in free solution in the pH range 3-5 using the Rotofor cell. When gel filtration by FPLC with the Superose 12 column was used as the final step, the combined sequence of purification procedures resulted in a 1600-fold purification of the IL-1 inhibitor. The purified IL-1 inhibitor has a molecular weight of approximately 52 +/- 4 kDa and a pI of 4.15 +/- 0.1. By SDS-PAGE analysis the inhibitor preparation thus obtained showed the presence of two protein bands, while a few closely spaced protein bands were seen by analytical isoelectric focusing in polyacrylamide gels (pH 3-6). Some of these bands in PAGIF might correspond to different degrees of glycosylation of the inhibitory protein. Although the M20 IL-1 inhibitor has not yet been purified to homogeneity, it should be stressed that the procedures used, allowed us to remove the great majority of the proteins present in the medium in which the M20 cells were cultured, and to recover in satisfactory yield the inhibitor which we consider likely to be present in the conditioned medium in subnanomolar concentrations.

Interleukin-1: local production and modulation of human granulosa luteal cells steroidogenesis

OBJECTIVES

To investigate the possibility of local interleukin-1 (IL-1) and IL-1 inhibitor production by human granulosa and cumulus cells and to assess their direct effects on the steroidogenesis of these cells in vitro.

DESIGN

Prospective study.

PARTICIPANTS

Normal ovulatory women undergoing ovulation induction for in vitro fertilization.

INTERVENTION

Pretreatment of patients with gonadotropin-releasing hormone analogue, human menopausal gonadotropin, and human chorionic gonadotropin (hCG).

MAIN OUTCOME MEASURES

Retrieval and isolation of granulosa luteal cells and follicular fluid (FF). Granulosa luteal cells and cumulus cells cultured and analyzed by fluorescent activated cell sorter. Follicular fluid separated and bioassayed for IL-1 and IL-1 inhibitory activity. Steroid measurement performed. Interleukin-1 inhibitor purified. Interleukin-1 and IL-1 inhibitor bioassay performed. Statistical analysis made and interpreted.

RESULTS

Interleukin-1, but not IL-1 specific inhibitory activity, was found in granulosa and cumulus cell cultures and also in FF, only after its purification on a high-pressure liquid chromatography column. Under nonstimulated conditions, neither IL-1 nor IL-1 inhibitor had any effect on basal progesterone (P) or estradiol (E2) secretion. However, IL-1 inhibitor demonstrated significant (P < 0.01) inhibition of hCG-stimulated P secretion (from 200 to 110 ng/10,000 cells per 24 hours). In addition, IL-1 demonstrated a significant (P < 0.05) and dose-dependent inhibition of hCG-stimulated E2 production (from 6,832 +/- 460 to 4,237 +/- 141 pg/10,000 cells per 24 hours).

CONCLUSIONS

Interleukin-1 may exert a significant local autocrine regulatory role in the human ovary.

Elevated serum levels of soluble tumour necrosis factor receptors (sTNF-R) in patients with HIV infection

Serum levels of the soluble form of tumour necrosis factor receptor type II (p75) (sTNF-R) were determined in HIV-infected individuals and risk groups and were then correlated with the course of infection and prognosis. sTNF-R levels were determined by an ELISA with MoAbs and polyclonal antibodies to urine-derived sTNF-R proteins. The mean +/- s.e. levels of sTNF-R in the sera of 49 HIV+ male homosexuals, 34 HIV- male homosexuals and 44 matched controls were 6.1 +/- 0.3 ng/ml, 4.4 +/- 0.3 ng/ml and 3.4 +/- 0.2 ng/ml, respectively. All these values were significantly different between each of the groups (P less than 0.001-0.05). Sequential studies of sTNF-R revealed higher levels following seroconversion in 5/8 individuals, remained persistently high during the asymptomatic phase of the infection and became even more elevated in some ARC and AIDS patients. At the same time TNF-alpha was undetectable in sera obtained from HIV+ male homosexuals and from healthy controls. This was independent of stage of HIV infection, serum sTNF-R level and type of ELISA kit used. These findings suggest that TNF-alpha/TNF-R system is turned on before and during HIV infection and raise the possibility that sTNF-R, the natural inhibitor of TNF, may be of importance in determining the course and probably prognosis of the disease.