Epstein – Barr viral load, interleukin-6 and interleukin-10 levels in post-transplant lymphoproliferative disease: A nested case – control study in a renal transplant cohort

Abstract

The possible correlation among Epstein - Barr virus (EBV) load, interleukin-6 (IL-6) and interleukin-10 (IL-10) levels has become an attractive issue and can provide a useful tool for diagnosis and monitoring of patients at risk for post-transplant lymphoproliferative disease (PTLD) development. At the time of diagnosis of PTLD, 11 patients were prospectively enrolled and 55 nested controls were selected from a 1800 renal transplant cohort. Real-time polymerase chain reaction (PCR) was used to quantify EBV load in peripheral blood mononuclear cells (PBMC). Serum IL-6 and IL-10 levels were determined using an enzyme-linked immunosorbent assay ( ELISA). the median EBV load of PTLD cases was 17400 copies/10(6) PBMC, statistically different from controls ( P = 0.001). the median IL-6 level of PTLD cases was not different from controls (P=0.079). However, median IL-10 levels showed a significant difference in both groups ( P <= 0.001). the receiver-operating characteristic (ROC) curve analysis was applied to estimate the IL-10 cut-off value predictive of PTLD development. We found that 73.5 pg/ml has high sensitivity (1.00) and specificity (0.85). Also, Pearson's analysis showed a strong correlation between EBV load and serum IL-10 concentration ( P <= 0.001). This nested case - control study demonstrates that EBV load at diagnosis of PTLD correlates with IL-10 levels, and that monitoring of IL-10 can provide a less expensive and less time-consuming tool for PTLD diagnosis and close follow-up of patients at risk. Furthermore, we were able to de. ne a cut-off value of IL-10 mostly predictive of PTLD development in this cohort. Our data suggest that serial measurements prior to PTLD development must be carried out to validate our hypothesis.Universidade Federal de São Paulo, EPM, Hematol & Transfus Med Serv, São Paulo, BrazilLudwig Inst Canc Res, São Paulo Branch, São Paulo, BrazilUNIFESP, EPM, Univ Hosp São Paulo, Discipline Nephrol, São Paulo, BrazilHosp Rim & Hipertensao, São Paulo, BrazilFleury Virol Div, São Paulo, BrazilUniversidade Federal de São Paulo, EPM, Dept Pathol, São Paulo, BrazilUniversidade Federal de São Paulo, EPM, Hematol & Transfus Med Serv, São Paulo, BrazilUNIFESP, EPM, Univ Hosp São Paulo, Discipline Nephrol, São Paulo, BrazilUniversidade Federal de São Paulo, EPM, Dept Pathol, São Paulo, BrazilWeb of Scienc