An elevated pro-inflammatory cytokine response is linked to development of amphotericin B-induced nephrotoxicity

作者：Chai Louis Y A; Netea Mihai G; Tai Bee Choo; Khin Lay Wai; Vonk Alieke G; Teo Boon Wee; Schlamm Haran T; Herbrecht Raoul; Donnelly J Peter; Troke Peter F; Kullberg Bart Jan^*

来源：Journal of Antimicrobial Chemotherapy, 2013, 68(7): 1655-1659.

DOI：10.1093/jac/dkt055

• immune responses
• drug induced
• acute kidney injury
• interleukins

The underlying mechanism for amphotericin B-induced acute kidney injury (AKI) remains poorly understood and may be immunologically mediated. We assessed whether the development of nephrotoxicity is linked to a distinct cytokine profile in patients receiving amphotericin B deoxycholate (AmBD). %26lt;br%26gt;In 58 patients who received AmBD, circulating serum interleukin (IL)-6, IL-8 and IL-10 were measured at baseline, week 1 and week 2 of antifungal treatment and correlated to the development of renal impairment. The Cox proportional hazards model approach was adopted for analysis. %26lt;br%26gt;The P value was 0.026 for the overall effect of IL-6 on time to development of AKI. An increasing or non-receding IL-6 trend by week 1 of AmBD treatment (followed by a decreasing or non-receding IL-6 trend from week 1 to week 2) correlated with an increased likelihood of nephrotoxicity [hazard ratio (HR) 6.93, P value 0.005 and HR 3.46, P value 0.035, respectively]. Similarly, persistently increasing IL-8 levels were linked to a 3.84-fold increased likelihood of AKI. %26lt;br%26gt;In patients receiving AmBD, persistence of an elevated pro-inflammatory cytokine milieu is associated with a predisposition to drug-related kidney injury.

• 出版日期2013-7