PMID- 1900552
OWN - NLM
STAT- MEDLINE
DCOM- 19910417
LR  - 20211203
IS  - 0085-2538 (Print)
IS  - 0085-2538 (Linking)
VI  - 39
IP  - 1
DP  - 1991 Jan
TI  - OKT3 first-dose reaction: association with T cell subsets and cytokine release.
PG  - 141-8
AB  - Use of the monoclonal antibody OKT3 to prevent or treat allograft rejection has 
      become commonplace. Its administration is often complicated by serious side 
      effects, usually occurring within one to two hours after OKT3 is given, and is 
      termed first-dose reaction. The mechanism underlying these signs and symptoms is 
      poorly defined, but may be related to cytokine release. Twenty-three kidney or 
      kidney/pancreas transplant recipients received OKT3 as treatment of acute 
      rejection. Signs and symptoms occurring after the first dose were observed and 
      quantitated prospectively, and a reaction score was calculated. Blood was drawn 
      immediately before, and at 2 and 24 hours after the first dose of OKT3 for 
      determination of interleukin-2 (IL2), interferon-gamma (IFN gamma), and tumor 
      necrosis factor-alpha (TNF alpha) levels, and flow cytometric analysis of T cell 
      subsets. Two groups were defined based on severity of first-dose reaction. Group 
      1 patients (N = 11) had very mild reactions (reaction score less than or equal to 
      3); Group 2 patients (N = 12) had more severe reactions (score greater than or 
      equal to 5). All patients demonstrated a significant rise in serum TNF alpha from 
      baseline to two hours after OKT3 (9 +/- 3 pg/ml to 378 +/- 54 pg/ml, P less than 
      0.0001), and there was significant correlation between reaction scores and 
      two-hour TNF alpha levels (P = 0.005). Group 2 patients had higher TNF alpha 
      levels at two hours than did Group 1 patients (484 +/- 75 pg/ml vs. 263 +/- 62 
      pg/ml, P = 0.04). Levels of IL2 and IFN gamma were not elevated at any sampling 
      time.(ABSTRACT TRUNCATED AT 250 WORDS)
FAU - Gaston, R S
AU  - Gaston RS
AD  - Department of Medicine, University of Alabama, Birmingham.
FAU - Deierhoi, M H
AU  - Deierhoi MH
FAU - Patterson, T
AU  - Patterson T
FAU - Prasthofer, E
AU  - Prasthofer E
FAU - Julian, B A
AU  - Julian BA
FAU - Barber, W H
AU  - Barber WH
FAU - Laskow, D A
AU  - Laskow DA
FAU - Diethelm, A G
AU  - Diethelm AG
FAU - Curtis, J J
AU  - Curtis JJ
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Kidney Int
JT  - Kidney international
JID - 0323470
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (Interleukin-2)
RN  - 0 (Muromonab-CD3)
RN  - 0 (Tumor Necrosis Factor-alpha)
RN  - 82115-62-6 (Interferon-gamma)
SB  - IM
MH  - Adult
MH  - Antibodies, Monoclonal/*adverse effects/therapeutic use
MH  - Female
MH  - Flow Cytometry
MH  - Graft Rejection/immunology
MH  - Humans
MH  - *Immunosuppression Therapy
MH  - Immunosuppressive Agents/therapeutic use
MH  - Interferon-gamma/*immunology
MH  - Interleukin-2/*immunology
MH  - Kidney Transplantation/immunology
MH  - Male
MH  - Muromonab-CD3
MH  - Pancreas Transplantation/immunology
MH  - T-Lymphocyte Subsets/*immunology
MH  - Tumor Necrosis Factor-alpha/*immunology
EDAT- 1991/01/01 00:00
MHDA- 1991/01/01 00:01
CRDT- 1991/01/01 00:00
PHST- 1991/01/01 00:00 [pubmed]
PHST- 1991/01/01 00:01 [medline]
PHST- 1991/01/01 00:00 [entrez]
AID - S0085-2538(15)57099-3 [pii]
AID - 10.1038/ki.1991.18 [doi]
PST - ppublish
SO  - Kidney Int. 1991 Jan;39(1):141-8. doi: 10.1038/ki.1991.18.