Laurence A. Rubin, MD; David L. Nelson, MD
Purpose: To review the biologic origin, functional characteristics, and current and potential clinical applications of a novel marker of immune system activation, the soluble interleukin-2 receptor (SIL-2R).
Data Identification: Studies reported since 1985 were identified by a computer search using MEDLINE as well as from bibliographies of published work.
Study Selection: Sixty-two reports on the clinical applications of the sIL-2R, largely from peer-reviewed journals, were identified. These reports address the utility and significance of sIL-2R measurements in various conditions. Basic scientific investigations delineating the biochemical and molecular features of the human interleukin-2 receptor complex and the sIL-2R protein were reviewed.
Data Extraction: The validity of sIL-2R quantitation as an index of in-vivo immune system activation and its usefulness as a measure of disease activity and outcome were examined.
Results of Data Analysis: The quantitation of sIL-2R, a novel laboratory measure of in-vivo immune system activation, correlates reliably with disease activity in autoimmune inflammatory disorders, transplantation rejection, and specific infectious disorders. Markedly elevated serum sIL-2R levels are a particularly prominent feature of certain hematologic malignancies, such as human T lymphotropic retrovirus type I-associated adult T-cell leukemia and hairy cell leukemia, reflecting tumor burden and response to therapy. The sIL-2R level at disease onset may also reliably predict long-term prognosis in non-Hodgkin lymphoma, and it appears to provide an additional serologic measure in the assessment of clinical progression in patients with human immunodeficiency virus infection and the acquired immunodeficiency syndrome.
Conclusions: Studies have suggested that sIL-2R levels offer a rapid, reliable, and noninvasive measure of disease activity, response to therapy, and, in some cases, prognosis in a broad spectrum of conditions associated with T- or B-cell immune activation.
Rubin LA, Nelson DL. The Soluble Interleukin-2 Receptor: Biology, Function, and Clinical Application. Ann Intern Med. ;113:619–627. doi: 10.7326/0003-4819-113-8-619
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Published: Ann Intern Med. 1990;113(8):619-627.
Hematology/Oncology, Infectious Disease, Leukemia/Lymphoma.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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