Transplantation

TNFa and interferon y (IFN7) are more sensitive parameters in mixed lymphocyte culture than proliferation and may be possible prospective parameters in bone marrow and organ transplantation. Graft-versus-host disease significantly correlates with enhanced TNFa, but not IL-1 and IL-6 serum levels in bone marrow recipients, even in transplantation of bone marrow from siblings. During acute graft rejection of organs, there is an increase in plasma levels of TNFa. In heart transplantation TNFd3 (associated with high production of TNFa) seems to be a risk factor, whereas the -308 polymorphism is of no relevance, because this promoter region is negatively regulated by cyclosporine. During kidney rejection there are increased TNFa levels resulting from an imbalance between TNFa and sTNFR, which is not observed during cyclosporine nephrotoxicity. In a rat model, anti-TNFa treatment extends allograft survival. This effect is enhanced by a combination of anti-TNFa and anti-IFNy.

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