Abstract
The role of interleukin 6 (IL-6) in the toxic sequelae of sepsis is controversial. To assess the part of IL-6 in inflammatory responses to endotoxin, we investigated eight chimpanzees after either a bolus intravenous injection of Escherichia coli endotoxin (n = 4; 4 ng/kg) or after the same dose of endotoxin with a simultaneous bolus intravenous injection of an anti-IL-6 mAb (30 mg; n = 4). Anti-IL-6 did not affect the induction of the cytokine network (tumor necrosis factor [TNF], soluble TNF receptors types I and II, and IL-8) by endotoxin, nor did it influence the occurrence of a neutrophilic leukocytosis and neutrophil degranulation, as monitored by the measurement of elastase- alpha 1-antitrypsin complexes. In contrast, anti-IL-6 markedly attenuated endotoxin-induced activation of coagulation, monitored with the plasma levels of the prothrombin fragment F1+2 and thrombin- antithrombin III complexes, whereas activation of fibrinolysis, determined with the plasma concentrations of plasmin-alpha 2- antiplasmin complexes, remained unaltered. We conclude that IL-6 does not have a feedback effect on the release of other cytokines after injection of endotoxin, and that it is not involved in endotoxin- induced neutrophilia or neutrophil degranulation. IL-6 is, however, an important intermediate factor in activation of coagulation in low grade endotoxemia in chimpanzees.
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- Aderka D., Le J. M., Vilcek J. IL-6 inhibits lipopolysaccharide-induced tumor necrosis factor production in cultured human monocytes, U937 cells, and in mice. J Immunol. 1989 Dec 1;143(11):3517–3523. [PubMed] [Google Scholar]
- Baggiolini M., Walz A., Kunkel S. L. Neutrophil-activating peptide-1/interleukin 8, a novel cytokine that activates neutrophils. J Clin Invest. 1989 Oct;84(4):1045–1049. doi: 10.1172/JCI114265. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Borish L., Rosenbaum R., Albury L., Clark S. Activation of neutrophils by recombinant interleukin 6. Cell Immunol. 1989 Jul;121(2):280–289. doi: 10.1016/0008-8749(89)90026-9. [DOI] [PubMed] [Google Scholar]
- Brakenhoff J. P., Hart M., De Groot E. R., Di Padova F., Aarden L. A. Structure-function analysis of human IL-6. Epitope mapping of neutralizing monoclonal antibodies with amino- and carboxyl-terminal deletion mutants. J Immunol. 1990 Jul 15;145(2):561–568. [PubMed] [Google Scholar]
- Cairns J. A., Guy G. R., Tan Y. H. Interleukin-6 regulates the cytotoxic effect of tumour necrosis factor on U937 cells. Immunology. 1992 Apr;75(4):669–673. [PMC free article] [PubMed] [Google Scholar]
- Cermak J., Key N. S., Bach R. R., Balla J., Jacob H. S., Vercellotti G. M. C-reactive protein induces human peripheral blood monocytes to synthesize tissue factor. Blood. 1993 Jul 15;82(2):513–520. [PubMed] [Google Scholar]
- Creasey A. A., Chang A. C., Feigen L., Wün T. C., Taylor F. B., Jr, Hinshaw L. B. Tissue factor pathway inhibitor reduces mortality from Escherichia coli septic shock. J Clin Invest. 1993 Jun;91(6):2850–2860. doi: 10.1172/JCI116529. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fernandez-Botran R. Soluble cytokine receptors: their role in immunoregulation. FASEB J. 1991 Aug;5(11):2567–2574. doi: 10.1096/fasebj.5.11.1868981. [DOI] [PubMed] [Google Scholar]
- Fong Y., Tracey K. J., Moldawer L. L., Hesse D. G., Manogue K. B., Kenney J. S., Lee A. T., Kuo G. C., Allison A. C., Lowry S. F. Antibodies to cachectin/tumor necrosis factor reduce interleukin 1 beta and interleukin 6 appearance during lethal bacteremia. J Exp Med. 1989 Nov 1;170(5):1627–1633. doi: 10.1084/jem.170.5.1627. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hack C. E., De Groot E. R., Felt-Bersma R. J., Nuijens J. H., Strack Van Schijndel R. J., Eerenberg-Belmer A. J., Thijs L. G., Aarden L. A. Increased plasma levels of interleukin-6 in sepsis. Blood. 1989 Oct;74(5):1704–1710. [PubMed] [Google Scholar]
- Hack C. E., Hart M., van Schijndel R. J., Eerenberg A. J., Nuijens J. H., Thijs L. G., Aarden L. A. Interleukin-8 in sepsis: relation to shock and inflammatory mediators. Infect Immun. 1992 Jul;60(7):2835–2842. doi: 10.1128/iai.60.7.2835-2842.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Helle M., Boeije L., Aarden L. A. Functional discrimination between interleukin 6 and interleukin 1. Eur J Immunol. 1988 Oct;18(10):1535–1540. doi: 10.1002/eji.1830181010. [DOI] [PubMed] [Google Scholar]
- Helle M., Boeije L., de Groot E., de Vos A., Aarden L. Sensitive ELISA for interleukin-6. Detection of IL-6 in biological fluids: synovial fluids and sera. J Immunol Methods. 1991 Apr 8;138(1):47–56. doi: 10.1016/0022-1759(91)90063-l. [DOI] [PubMed] [Google Scholar]
- Heremans H., Dillen C., Put W., Van Damme J., Billiau A. Protective effect of anti-interleukin (IL)-6 antibody against endotoxin, associated with paradoxically increased IL-6 levels. Eur J Immunol. 1992 Sep;22(9):2395–2401. doi: 10.1002/eji.1830220932. [DOI] [PubMed] [Google Scholar]
- Le J. M., Vilcek J. Interleukin 6: a multifunctional cytokine regulating immune reactions and the acute phase protein response. Lab Invest. 1989 Dec;61(6):588–602. [PubMed] [Google Scholar]
- Levi M., Hack C. E., de Boer J. P., Brandjes D. P., Büller H. R., ten Cate J. W. Reduction of contact activation related fibrinolytic activity in factor XII deficient patients. Further evidence for the role of the contact system in fibrinolysis in vivo. J Clin Invest. 1991 Oct;88(4):1155–1160. doi: 10.1172/JCI115416. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Levi M., ten Cate H., Bauer K. A., van der Poll T., Edgington T. S., Büller H. R., van Deventer S. J., Hack C. E., ten Cate J. W., Rosenberg R. D. Inhibition of endotoxin-induced activation of coagulation and fibrinolysis by pentoxifylline or by a monoclonal anti-tissue factor antibody in chimpanzees. J Clin Invest. 1994 Jan;93(1):114–120. doi: 10.1172/JCI116934. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Levi M., ten Cate H., van der Poll T., van Deventer S. J. Pathogenesis of disseminated intravascular coagulation in sepsis. JAMA. 1993 Aug 25;270(8):975–979. [PubMed] [Google Scholar]
- Libert C., Vink A., Coulie P., Brouckaert P., Everaerdt B., Van Snick J., Fiers W. Limited involvement of interleukin-6 in the pathogenesis of lethal septic shock as revealed by the effect of monoclonal antibodies against interleukin-6 or its receptor in various murine models. Eur J Immunol. 1992 Oct;22(10):2625–2630. doi: 10.1002/eji.1830221023. [DOI] [PubMed] [Google Scholar]
- Lu Z. Y., Brochier J., Wijdenes J., Brailly H., Bataille R., Klein B. High amounts of circulating interleukin (IL)-6 in the form of monomeric immune complexes during anti-IL-6 therapy. Towards a new methodology for measuring overall cytokine production in human in vivo. Eur J Immunol. 1992 Nov;22(11):2819–2824. doi: 10.1002/eji.1830221110. [DOI] [PubMed] [Google Scholar]
- Nuijens J. H., Abbink J. J., Wachtfogel Y. T., Colman R. W., Eerenberg A. J., Dors D., Kamp A. J., Strack van Schijndel R. J., Thijs L. G., Hack C. E. Plasma elastase alpha 1-antitrypsin and lactoferrin in sepsis: evidence for neutrophils as mediators in fatal sepsis. J Lab Clin Med. 1992 Feb;119(2):159–168. [PubMed] [Google Scholar]
- Schindler R., Mancilla J., Endres S., Ghorbani R., Clark S. C., Dinarello C. A. Correlations and interactions in the production of interleukin-6 (IL-6), IL-1, and tumor necrosis factor (TNF) in human blood mononuclear cells: IL-6 suppresses IL-1 and TNF. Blood. 1990 Jan 1;75(1):40–47. [PubMed] [Google Scholar]
- Thompson J. M., Gralow J. R., Levy R., Miller R. A. The optimal application of forward and ninety-degree light scatter in flow cytometry for the gating of mononuclear cells. Cytometry. 1985 Sep;6(5):401–406. doi: 10.1002/cyto.990060503. [DOI] [PubMed] [Google Scholar]
- Ulich T. R., del Castillo J., Guo K. Z. In vivo hematologic effects of recombinant interleukin-6 on hematopoiesis and circulating numbers of RBCs and WBCs. Blood. 1989 Jan;73(1):108–110. [PubMed] [Google Scholar]
- Van Bladel S., Libert C., Fiers W. Interleukin-6 enhances the expression of tumor necrosis factor receptors on hepatoma cells and hepatocytes. Cytokine. 1991 Mar;3(2):149–154. doi: 10.1016/1043-4666(91)90036-d. [DOI] [PubMed] [Google Scholar]
- Van Zee K. J., Fischer E., Hawes A. S., Hébert C. A., Terrell T. G., Baker J. B., Lowry S. F., Moldawer L. L. Effects of intravenous IL-8 administration in nonhuman primates. J Immunol. 1992 Mar 15;148(6):1746–1752. [PubMed] [Google Scholar]
- Van Zee K. J., Kohno T., Fischer E., Rock C. S., Moldawer L. L., Lowry S. F. Tumor necrosis factor soluble receptors circulate during experimental and clinical inflammation and can protect against excessive tumor necrosis factor alpha in vitro and in vivo. Proc Natl Acad Sci U S A. 1992 Jun 1;89(11):4845–4849. doi: 10.1073/pnas.89.11.4845. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Waage A., Brandtzaeg P., Halstensen A., Kierulf P., Espevik T. The complex pattern of cytokines in serum from patients with meningococcal septic shock. Association between interleukin 6, interleukin 1, and fatal outcome. J Exp Med. 1989 Jan 1;169(1):333–338. doi: 10.1084/jem.169.1.333. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Yuo A., Kitagawa S., Kasahara T., Matsushima K., Saito M., Takaku F. Stimulation and priming of human neutrophils by interleukin-8: cooperation with tumor necrosis factor and colony-stimulating factors. Blood. 1991 Nov 15;78(10):2708–2714. [PubMed] [Google Scholar]
- van Deventer S. J., Büller H. R., ten Cate J. W., Aarden L. A., Hack C. E., Sturk A. Experimental endotoxemia in humans: analysis of cytokine release and coagulation, fibrinolytic, and complement pathways. Blood. 1990 Dec 15;76(12):2520–2526. [PubMed] [Google Scholar]
- van Deventer S. J., Hack C. E., Wolbink C. E., Voermans H. J., Strack van Schijindel R. J., ten Cate J. W., Thijs L. G. Endotoxin-induced neutrophil activation--the role of complement revisited. Prog Clin Biol Res. 1991;367:101–109. [PubMed] [Google Scholar]
- van Leenen D., van der Poll T., Levi M., ten Cate H., van Deventer S. J., Hack C. E., Aarden L. A., ten Cate J. W. Pentoxifylline attenuates neutrophil activation in experimental endotoxemia in chimpanzees. J Immunol. 1993 Aug 15;151(4):2318–2325. [PubMed] [Google Scholar]
- van der Poll T., Levi M., van Deventer S. J., ten Cate H., Haagmans B. L., Biemond B. J., Büller H. R., Hack C. E., ten Cate J. W. Differential effects of anti-tumor necrosis factor monoclonal antibodies on systemic inflammatory responses in experimental endotoxemia in chimpanzees. Blood. 1994 Jan 15;83(2):446–451. [PubMed] [Google Scholar]
- van der Poll T., van Deventer S. J., Hack C. E., Wolbink G. J., Aarden L. A., Büller H. R., ten Cate J. W. Effects on leukocytes after injection of tumor necrosis factor into healthy humans. Blood. 1992 Feb 1;79(3):693–698. [PubMed] [Google Scholar]