Interleukin 6, the third mediator of acute-phase reaction, modulates hepatic protein synthesis in human and mouse. Comparison with interleukin 1 beta and tumor necrosis factor-alpha

Plasma haptoglobin in cattle (Bos taurus) exists as polymers in association with albumin

1. Plasma haptoglobin (Hp) in cattle (Bos taurus) has a molecular mass so large that it is virtually unable to penetrate 4% polyacrylamide gels and is excluded from gel filtration media with an upper exclusion limit of greater than 1000 kDa. 2. In most species, apart from ruminants, Hp has a molecular mass of 100 kDa, consisting of two subunits of 40 kDa and two subunits of 9 kDa, although in a few species, such as man, a genetic variant of Hp forms polymers of higher mass. 3. Bovine Hp was purified by (i) salt precipitation, gel filtration and ion exchange chromatography and (ii) by affinity chromatography and gel filtration, with final purification by (iii) preparative electrophoresis. 4. Bovine Hp could only penetrate sodium dodecyl sulphate polyacrylamide gels following denaturation with mercaptoethanol, when it was shown to be composed of subunits of 40 and 16 kDa, but a protein of 67 kDa was consistently present. 5. Western blotting identified the 67 kDa protein as bovine serum albumin. 6. The polymeric form of Hp found in bovine plasma is formed by association of 40 and 16 kDa subunits with albumin.

Epidermal growth factor and transforming growth factor-beta differently modulate the acute phase response elicited by interleukin-6 in cultured liver cells from man, rat and mouse

1. Complex effects of principal inflammatory cytokines (IL-6, IL-1, TNF, IFN-gamma) on acute phase protein synthesis and other metabolic processes in cultured liver cells are briefly reviewed. 2. Molecular properties and biological functions of transforming growth factor-beta and epidermal growth factor are compared. 3. The effects of these factors with respect to both amino acid uptake and acute phase protein synthesis are described in detail. The results are found to be different for rat or mouse hepatocytes and human hepatoma cells.

Regulation of interleukin 6 receptor expression in human monocytes and monocyte-derived macrophages. Comparison with the expression in human hepatocytes

IL-6 is a cytokine with pleiotropic biological functions, including induction of the hepatic acute phase response and differentiation of activated B cells into Ig-secreting plasma cells. We found that human peripheral blood monocytes express the IL-6-R, which is undetectable on the large majority of lymphocytes of healthy individuals. Stimulation of monocytes by endotoxin or IL-1 causes a rapid downregulation of IL-6-R mRNA levels and a concomitant enhancement of IL-6 mRNA expression. IL-6 itself was found to suppress the IL-6-R at high concentrations. A gradual decrease of IL-6-R mRNA levels was observed along in vitro maturation of monocytes into macrophages. We show that downregulation of IL-6-R mRNA levels by IL-1 and IL-6 is monocyte specific, since IL-6-R expression is stimulated by both IL-1 and IL-6 in cultured human primary hepatocytes. Our data indicate that under noninflammatory conditions, monocytes may play a role in binding of trace amounts of circulating IL-6. Repression of monocytic IL-6-R and stimulation of hepatocytic IL-6-R synthesis may represent a shift of the IL-6 tissue targets under inflammatory conditions.

Inflammatory microcrystals stimulate interleukin-6 production and secretion by human monocytes and synoviocytes

Crystal-related joint diseases are often associated with systemic inflammatory manifestations, including increased levels of acute-phase proteins, leukocytosis, and fever. Recently, interleukin-6 (IL-6) has been identified as a pluripotent mediator of inflammatory and immunologic responses and the major hepatocyte-stimulating factor. In this study, we demonstrated that monosodium urate (MSU) and calcium pyrophosphate dihydrate (CPPD) crystals, and to a lesser extent, hydroxyapatite crystals, increased IL-6 production by synoviocytes and monocytes in vitro. Immunoprecipitation experiments showed that MSU and CPPD crystals, but not hydroxyapatite crystals, were able to increase the release of newly synthesized IL-6. Crystal-induced IL-6 stimulated acute-phase protein synthesis, immunoglobulin production, and hybridoma cell proliferation, which was neutralized by a specific antibody to IL-6. High levels of IL-6 were found in synovial fluid from patients with gout and pseudogout. These results demonstrate that MSU and CPPD crystals can induce IL-6 production in synoviocytes and monocytes, and that synovial fluid from patients with gout and pseudogout contains high levels of IL-6. Crystal-induced IL-6 is likely to be an important mediator of inflammatory responses in acute gout and pseudogout.

Antibodies to cachectin/tumor necrosis factor reduce interleukin 1 beta and interleukin 6 appearance during lethal bacteremia

Cytokines secreted in response to invading micro-organisms are important mediators of detrimental hemodynamic and metabolic changes in the host. To test whether cachectin/TNF plays a role in triggering release of other cytokines in the setting of infection, anesthetized baboons were passively immunized against systemic cachectin/TNF before infusion of a LD100 dose of live Escherichia coli. Bacteremia led to significant increases in circulating levels of cachectin/TNF, IL-1 beta, and IL-6. Although bacterial endotoxin/lipopolysaccharide is a potent stimulus for the synthesis and release of IL-1 and IL-6 in vitro, specific neutralization of cachectin/TNF in vivo with mAb pretreatment significantly attenuated both the IL-1 beta and the IL-6 responses despite fulminant overwhelming bacteremia. These data suggest that cachectin/TNF is essential for the initiation or amplification of IL-1 and IL-6 release during lethal gram-negative septic shock syndrome.

Monitoring the acute phase response: comparison of tumour necrosis factor (cachectin) and C-reactive protein responses in inflammatory and infectious diseases

The relation between the inflammatory cytokine tumour necrosis factor-alpha (TNF or cachectin), which induces acute phase responses, and an established acute phase protein, C-reactive protein, was studied in various infectious and inflammatory diseases in man. All cases with very high serum concentrations of C-reactive protein (150 to 400 mg/l; normal reference value less than 10 mg/l) also had raised serum concentrations of TNF (53 to 705 ng/l; normal reference value less than 40 ng/l). In 19 out of 91 (21%) of the cases, however, a raised TNF concentration without correspondingly raised C-reactive protein concentration was also noted. Conversely, in 23 out of 106 (22%) cases raised C-reactive protein was observed in the absence of a raised TNF concentration. The ratios were high in allograft rejection and low in myocardial infarction and Kawasaki's disease. The highest mean concentration of circulating TNF was found in bacterial infections, graft rejection, and myocardial infarction. It is concluded that although high C-reactive protein concentrations are usually accompanied by raised TNF concentrations, there are pronounced relative variations in the serum concentrations of these proteins in various disease states, suggesting that there may be independent, disease specific regulatory pathways for TNF and C-reactive protein.

Elevated tumor necrosis factor alpha and interleukin-6 serum levels as markers for complicated Plasmodium falciparum malaria

PURPOSE

Tumor necrosis factor alpha (TNF-alpha) has been implicated in the pathology of experimental malaria. To establish its relevance to human malaria, we studied serum levels of two monocyte-derived cytokines, TNF-alpha and interleukin-6 (IL-6), as well as of the lymphocyte-derived mediator interferon gamma (IFN-gamma) in patients with malaria before and during antiparasitic treatment.

PATIENTS AND METHODS

One hundred twenty serum samples of 40 patients with malaria (Plasmodium falciparum [n = 32], Plasmodium vivax [n = 8]) were analyzed. IL-6 was measured by a highly sensitive and specific bioassay, TNF-alpha by immunoradiometric assay, and IFN-gamma by radioimmunoassay.

RESULTS

Elevated cytokine levels could be detected in the majority of patients with P. falciparum malaria before treatment (31 of 32, 21 of 32, and 21 of 32 for TNF-alpha, IL-6, and IFN-gamma, respectively), but only in some patients with P. vivax malaria (four of eight, one of eight, and zero of eight for TNF-alpha, IL-6, and IFN-gamma, respectively). Serum concentrations of the monokines TNF-alpha and IL-6 correlated significantly with parasitic density (p less than 0.001). No such correlation was obtained with the circulating IFN-gamma concentration. The levels of monokines TNF-alpha and IL-6 were markedly elevated in 18 P. falciparum-infected patients with complicated clinical courses (median values for TNF-alpha 172 pg/mL, for IL-6 16 U/mL, peak values: 896 pg/mL and 1,000 U/mL, respectively). The correlation between TNF-alpha and IL-6 concentrations in serum (n = 40, r = 0.56, p = 0.0002) suggests co-ordinate production of those mediators.

CONCLUSION

Organ impairment in human malaria was found to be correlated with the amount of circulating cytokine levels of TNF-alpha and IL-6. Thus, imbalances of the cytokine network in untreated P. falciparum infection serve as markers of severity of disease. Modulation of cytokine response could represent a novel approach to the treatment of severe organ dysfunctions in human malaria.

Regulation of hepatic synthesis of C3 and C4 during the acute-phase response in the rat

Following the i.p. injection of casein, rats showed increased serum levels of C4 and C3. C4 levels peaked on day 2 and returned to normal by day 4, while C3 levels peaked on day 3 before returning to normal on day 4. These changes were paralleled by changes in the hepatocyte synthesis rates of these two proteins. Macrophages, isolated from the peritoneal cavities of rats on days 1 to 7 (day-1 to day-7 macrophages) following i.p. injection of casein, were cultured in vitro, and the peritoneal macrophage-conditioned media (PMCM) assayed for their abilities to stimulate synthesis of C4 and C3 by hepatocytes from control rats. Day-2 PMCM selectively stimulated synthesis of C4, while day-3 and day-4 PMCM selectively stimulated C3 synthesis. These activities were called C4-hepatocyte stimulating factor (C4-HSF) and C3-HSF, respectively. The addition of anti-interleukin (IL) 1, tumor necrosis factor (TNF)-alpha, TNF-beta, IL 6 or interferon (IFN)-gamma antibodies to day-2 PMCM did not affect C4-HSF activity, and none had any effect on C3-HSF activity in day-4 PMCM. However, the addition of anti-IL 1 to day-4 PMCM resulted in the re-expression of C4-HSF activity as well as loss of thymocyte proliferative activity. C4-HSF activity could also be detected in day-4 PMCM by separating it from IL 1 activity using gel filtration chromatography. Furthermore the addition of recombinant IL 1 beta to day-2 PMCM prevented the expression of C4-HSF activity. Thus IL 1 appears to play a regulatory role in the acute-phase response in the rat, by preventing the expression of C4-HSF activity. The identities of C4-HSF activity and C3-HSF are still unknown but we believe that C3-HSF activity could be IL 6 as it has a similar molecular weight (30 kDa) and purified human IL 6 was more effective than IL 1, TNF-alpha or TNF-beta in stimulating C3 synthesis by rat hepatocytes. C4-HSF activity appears to be a property of a previously undescribed cytokine. It is not IL 1 alpha or beta, TNF-alpha or -beta, IL 6 or IFN-gamma.

Interleukin-6 and its receptor during homeostasis, inflammation, and tumor growth

This review focuses on describing the specific role of interleukin-6 within the network of inflammatory mediators in man. Sites of interleukin-6 synthesis, regulation of its expression, and the biological functions of this molecule are here outlined. The potential role of interleukin-6 as a diagnostic monitor is discussed. Particular attention is paid to experimental evidence that interleukin-6 and its receptor may be involved in the pathogenesis of autocrine tumor growth. A recently proposed therapeutical use of cytotoxic interleukin-6 fusion proteins in order to selectively, destroy certain interleukin-6 receptor bearing tumor cells is discussed in the light of the finding, that not only hepatocytes, but also normal peripheral blood monocytes express the interleukin-6 receptor.

The primary structure of equine serum amyloid A (SAA) protein

The complete amino acid sequence of equine serum amyloid A (SAA) was elucidated. The protein consists of 110 amino acid residues and contains an 8-amino acid residue insertion tentatively located between positions 69 and 70, as compared with human SAA. Microheterogeneities were detected at positions 16, 44, and 59, compatible with the existence of more than one SAA gene in the horse. This corresponds to the situation in man and mouse. Pronounced homology with SAA from man and several animal species was observed, thus confirming the conserved structure of this acute phase reactant and apoprotein of high-density lipoprotein (HDL).

Regulation of interleukin-6 receptor expression in human monocytes and hepatocytes

Human blood monocytes normally express the interleukin-6 receptor. Treatment of cultured monocytes with endotoxin, interleukin-1 beta, or interleukin-6 results in a decrease in interleukin-6 receptor mRNA levels. Glucocorticoids aso cause a drop in monocytic interleukin-6 receptor mRNA levels. We also found interleukin-6 receptor expression in cultured human hepatocytes, but in contrast to monocytes, where interleukin-6 receptor mRNA is presented by the ligand and by interleukin-1, treatment of hepatocytes with interleukin-6 or interleukin-1 resulted in increased interleukin-6 receptor mRNA levels. Induction of interleukin-6 receptor mRNA in hepatocytes was less pronounced when glucocorticoids were omitted from the culture medium. We conclude that during noninflammatory homeostasis, blood monocytes are involved in binding of trace amounts of circulating interleukin-6. During inflammatory events, the main target of interleukin-6 may be changed from the monocytic population not only to activated B-cells, but also to the hepatocytes.