Email this article An IL-6 level in the serum and urine in estimation of cryoglobulinemic vasculitis activity in patients with chronic hepatitis C associated with renal damage
- Authors: Korotchaeva Y.V.1, Kozlovskaya L.V.1, Gordovskaya N.B.1, Speranskiy A.I.1, Korotchaeva Y.V2, Kozlovskaya LV3, Gordovskaya NB2, Speransky AI4
-
Affiliations:
- I.M. Sechenov State Medical University, Moscow
- Nephrology and Occupational Diseases Clinic, Moscow
- Institute of Rheumatology, Moscow
- Issue: Vol 83, No 2 (2011)
- Pages: 52-56
- Section: Editorial
- URL: https://ter-arkhiv.ru/0040-3660/article/view/30804
- ID: 30804
Cite item
Full Text
Abstract
Aim. To estimate serum and urine IL-6 levels and to study its role in diagnosis of nephritis activity in patients with cryoglobulinemic glomerulonephritis (CGN) associated with chronic hepatitis C (CHC).
Material and methods. Enzyme immunoassay was used to assay IL-6 in blood serum of 124 patients having different stages of CHC. IL-6 was also estimated in the urine of 57 patients with CHC systemic manifestations including renal damage.
Results. Abnormal serum IL-6 level was seen in 36% CHC patients. Patients with elevated level of IL-6 in the serum vs patients with normal IL-6 level had cryoglobulinemia (CGE) (56% vs 26%, p < 0.01) and related systemic manifestations including cryoglobulinemic glomerulonephritis (30% vs 9%, p < 0.01). Most of (90%) patients with CHC-associated CGN had urinary IL-6 excretion correlating with severity of renal damage: the highest urinary level of IL-6 was seen in development of acute nephritic and nephritic syndromes (from 83.5 to 250 pg/ml). It did not correlate with IL-6 in the serum and proteinuria. This is evidence that IL-6 in the urine had a local origin (intrarenal), reflecting activity of immune inflammation in the kidney.
Conclusion. Control of IL-6 levels in the blood serum and urine of patients suffering from CHC with cryoglobulinemic syndrome and renal damage can be used for monitoring of the disease activity.
Material and methods. Enzyme immunoassay was used to assay IL-6 in blood serum of 124 patients having different stages of CHC. IL-6 was also estimated in the urine of 57 patients with CHC systemic manifestations including renal damage.
Results. Abnormal serum IL-6 level was seen in 36% CHC patients. Patients with elevated level of IL-6 in the serum vs patients with normal IL-6 level had cryoglobulinemia (CGE) (56% vs 26%, p < 0.01) and related systemic manifestations including cryoglobulinemic glomerulonephritis (30% vs 9%, p < 0.01). Most of (90%) patients with CHC-associated CGN had urinary IL-6 excretion correlating with severity of renal damage: the highest urinary level of IL-6 was seen in development of acute nephritic and nephritic syndromes (from 83.5 to 250 pg/ml). It did not correlate with IL-6 in the serum and proteinuria. This is evidence that IL-6 in the urine had a local origin (intrarenal), reflecting activity of immune inflammation in the kidney.
Conclusion. Control of IL-6 levels in the blood serum and urine of patients suffering from CHC with cryoglobulinemic syndrome and renal damage can be used for monitoring of the disease activity.
Keywords
About the authors
Yuliya Vyacheslavovna Korotchaeva
Email: lumis-j@bk.ru
Lidiya Vladimirovna Kozlovskaya
Nadezhda Borisovna Gordovskaya
Anatoliy Illarionovich Speranskiy
Yu V Korotchaeva
I.M. Sechenov State Medical University, MoscowI.M. Sechenov State Medical University, Moscow
L V Kozlovskaya
Nephrology and Occupational Diseases Clinic, MoscowNephrology and Occupational Diseases Clinic, Moscow
N B Gordovskaya
I.M. Sechenov State Medical University, MoscowI.M. Sechenov State Medical University, Moscow
A I Speransky
Institute of Rheumatology, MoscowInstitute of Rheumatology, Moscow
References
- Гордовская Н. Б. Варианты поражения почек при HCV-инфекции. Гепатол. форум 2005; 3: 13-15.
- Козловская Л. В. Поражение почек, ассоциированное с вирусами гепатитов В и С. В кн.: Практическая гепатология. М.; 2004. 177-186.
- Мухин Н. А., Козловская Л. В., Малышко Е. Ю. Криоглобулинемический нефрит, ассоциированный с хронической инфекцией вируса гепатита С. Тер. арх. 2000; 6: 1-5.
- Hamida F. B., Aoudia R. et al. Membranoproliferative glomerulonephritis in patients with cryoglobulinemia complicating hepatitis C virus: report of 11 cases. Tunis. Méd. 2007; 85 (3): 220-224.
- Feldmann G., Nischalke H. D., Nattermann J., Banas B. Induction of interleukin-6 by hepatitis C virus core protein in hepatitis C-associated mixed cryoglobulinemia and B-cell non-Hodgkin's lymphoma. Clin. Cancer Res. 1006; 12: 4491- 4498.
- Масалова О. В., Абдулмеджидова А. Г., Моргунов К. В. и др. Изменение показателей гуморального и клеточного иммунитета у пациентов с хроническим гепатитом С различной тяжести. Вопр. вирусол. 2003; 48 (3): 15-19.
- Harada K., Akai Y., Kurumatani N. et al. Prognostic value of urinary interleukin 6 in patients with IgA nephropathy: an 8-year follow-up study. Nephron 2002; 92 (4): 824-826.
- Malaguarnera M., Di Fazio I., Laurino A. et al. Serum interleukin 6 concentrations in chronic hepatitis C patients before and after interferon-α treatment. Int. J. Clin. Pharmacol. Ther. 1997; 35: 385-388.
- Игнатова Т. М. Хронический гепатит С. В кн.: Практическая гепатология. М.; 2004. 78-96.
- Dore M. P., Fattovich G., Sepulveda A. R., Realdi G. Cryoglobulinemia related to hepatitis C virus infection. Dig. Dis. Sci. 2007; 52 (4): 897-907.
- Huang Y. S., Hwang S. J., Chan C. Y. et al. Serum levels of cytokines in hepatitis C-related liver disease: a longitudinal study. Zhonghua Yi Xue Za Zhi (Taipei) 1999; 62: 327-333.
- Логинов А. С., Царегородцева Т. М., Зотина М. М. и др. Интерлейкины при хроническом вирусном гепатите. Тер. арх. 2001; 2: 17-20.
- Iwano M., Dohi K., Hirata E. et al. Urinary levels of IL-6 in patients with active lupus nephrite. Clin. Nephrol. 1993; 40 (1): 16-21.
- Fukatsu A., Matsio S., Tamai H. et al. Distribution of interleukin-6 in normal and diseased human kidney. Lab. Invest. 1991; 65: 61.
- Zhang K. F., Zhang L., Wu X. F. et al. Pathogenesis of rat mesangial proliferative glomerulonephritis induced by anti-Thy1 antibody. Sichuan Da Xue Xue Bao Yi Xue Ban 2004; 35 (2): 188-190.
- Eitner F., Westerhuis R., Burg M. et al. Role of interleukin-6 in mediating mesangial cell proliferation and matrix production in vivo. Kidney Int. 1997; 51 (1): 69-78.
- Hrvacevic R., Topalov D., Stojanovic R. et al. Serum and urinary interleukin-6 levels in patients with primary glomerulonephritis. Srp. Arh. Celok. Lek. 1996; 124 (1): 40-42.
- Nakamura T., Miller D., Ruoslahti E. et al. Production of extracellular matrix by glomerular epithelial cells is regulated by transforming growth factor-beta1. Kidney Int. 1992; 41: 1213- 1222.
- Ohta K., Takano N., Seno A. et al. Detection and clinical usefulness of urinary interleukin-6 in the diseases of the kidney and the urinary tract. Clin. Nephrol. 1992; 38 (4): 185-189.
- Marcellin P., Asselah T., Boyer N. Fibrosis and disease progression in hepatitis C. Hepatology 2002; 36 (suppl. 1): 47-57.
- Galossi A., Guarisco R., Bellis L., Puoti C. Extrahepatic manifestations of chronic HYCV infection. J. Gastrointest. Liver Dis. 2007; 16 (1): 65-73.
- Lapinski T. W. The levels of cytokines in HCV patients. Arch. Immun. Ther. Exp. 2001; 49: 311-316.
- Roccatello D., Fornasieri A., Giachino O. et al. Multicenter study on hepatitis C virus-related cryoglublinemic glomerulonephritis. Am. J. Kidney Dis. 2007; 49 (1): 69-82.
- Barsoum Rashad S. Hepatitis C virus: from entry to renal injury - facts and potentials. Nephrol. Dial. Transplant. 2007; 22: 1840-1848.
- Sansonno D., Dammacco F. Hepatitis C virus, cryoglobulinemia, and vasculitis: immune complex relations. Lancet 2005; 1 (5): 227-236.
Supplementary files
