肺结核患者支气管肺泡灌洗液中某些细胞因子与受体的检测及其临床意义

目的 研究肺结核患者支气管肺泡灌洗液(BALF)中TNF-α及受体、IL-1β及受体的特征及其临床意义,并探讨其在结核病免疫发病中的作用.方法 采用双抗体夹心ABC-ELISA法检测46例活动性肺结核患者、21例非活动性肺结核患者BALF及血清和20例健康者血清TNF-α、可溶性TNF受体(sTNF-R)Ⅰ、IL-1β、IL-1受体水平,对其中19例活动性肺结核患者抗结核治疗后的上述细胞因子水平进行随访.组间比较采用t检验.结果 活动性肺结核组BALF中TNF-α、sTNF-R Ⅰ、IL-1β、IL-1受体水平及TNF-α/sTNF-R Ⅰ比值分别为(286.2±96.3)、(2 431.5±1 124.6)、(58.6±3.2)、(162.4±17.1)pg/L和0.06±0.01,显著高于非活动性肺结核组(t值分别为3.36、3.25、2.95、2.27和3.12,均P<0.05).空洞组BALF中TNF-α、sTNF-R Ⅰ、IL-1β、IL-1受体水平及TNF-α/sTNF-R Ⅰ比值分别为(381.4±106.4)、(2 824.7±1 318.5)、(66.4±4.6)、(176.4±18.7)pg/L和0.07±0.01,均显著高于无空洞组(t值分别为3.46、2.37、3.19、2.99和3.22,均P<0.05).抗结核治疗2个月末,19例患者中有16例患者BALF中TNF-α、sTNF-RI、IL-1β、IL-1受体水平及TNF-α/sTNF-R Ⅰ比值较治疗前明显降低(t值分别为3.26、3.17、3.28、2.92和3.12,均P<0.01),且上述患者临床症状改善,痰菌阴转,胸部X线片病灶吸收、空洞缩小或闭合.结论 TNF-α、sTNF-R Ⅰ、IL-1β、IL-1受体等均参与结核病免疫发病过程.肺结核患者BALF中TNF-α、sTNF-R Ⅰ、IL-1β、IL-1受体水平的检测可作为了解疾病活动性、判断病情及预后、监测抗结核疗效的参考.     

肿瘤坏死因子-α、白细胞介素-1 β、-6水平与充血性心力衰竭关系的临床研究

目的探讨肿瘤坏死因子α(TNFα)、白细胞介素1β(IL1β)、白细胞介素6(IL6)与充血性心力衰竭(CHF)的关系。方法采用放射免疫分析法(RIA)测定三组入选者血清TNFα、IL1β、IL6的含量,CHF心功能Ⅰ、Ⅱ级组(30例),CHF心功能Ⅲ、Ⅳ级组(30例),对照组(28例)。结果心功能Ⅲ、Ⅳ级组患者血清TNFα、IL1β、IL6含量显著高于对照组(P<0.01)和心功能Ⅰ、Ⅱ级组(P<0.05),心功能Ⅰ、Ⅱ级组显著高于对照组(P<0.01);TNFα与IL1β、IL6呈显著正相关(r1=0.763,r2=0.684均P<0.01)。结论TNFα、IL1β、IL6水平与CHF发生发展密切有关。     

细胞因子在急性心肌梗塞中的作用

为探讨细胞因子在急性心肌梗塞（AMI）中的作用，测定了28例AMI患者血清肿瘤坏死因子α（TNFα）和白细胞介素1β（IL－β）水平，并选择13例不稳定型心绞痛（UA）患者和15例健康人作为对照。结果表明：AMI组血清TNFα水平明显高于UA组及正常组（P＜0．01），UA组血清TNFα水平明显高于正常组（P＜0．01）；血清IL－1β水平在严重的AMI患者（心功能KillipⅢ、Ⅳ级）明显高于正常组（P＜0．01）。提示血清TNFα和IL-1β水平与心肌缺血的严重程度有关。     

培哚普利对老年充血性心力衰竭患者血清炎性细胞因子的影响

目的 观察培哚普利对老年充血性心力衰竭(CHF)患者血清中肿瘤坏死因子(TNF—α)、白细胞介素—1(IL-1β)、白细胞介素-6(IL-6)的影响．方法 放免法检测53例老年CHF患者(培哚普利组28例，常规治疗组25例)治疗前后及25例健康老年人血清中TNF-α、IL-1β、IL—6水平．结果 老年CHF患者血清中TNF—α、IL-1β、IL—6水平显著高于对照组(P＜0．01)，且随着心功能损害程度加重而升高，TNF—α、IL—6水平在心功能各组间比较有显著性差异(P＜0．05)，IL—1β水平在心功Ⅳ级显著高于心功能Ⅱ、Ⅲ级(P＜0．05)．培哚普利组与常规治疗组老年CHF治疗后血清炎性细胞因子浓度均有明显降低，但培哚普利组TNF—α、IL-1β、IL—6水平下降更为明显(P＜0．05)。结论 血清中TNF—α、IL—1β、IL-6水平可反映心力衰竭的程度；培哚普利可明显降低老年CHF患者血清TNF—α、IL-1β、IL—6水平，从而保护和改善心脏功能．     

肺结核患者血清白细胞介素-12、13水平的临床研究

目的探讨初治肺结核患者血清白细胞介素12、13(IL12、IL13)水平改变及其临床意义,并了解其治疗的反应。方法采用酶联免疫双抗体夹心法(ELISA)检测肺结核患者治疗前、抗结核治疗6个月末组和对照组血清IL12和IL13的水平,并对其结果进行分析。结果肺结核患者治疗前血清IL12明显低于对照组和抗结核治疗6个月末组(P<0.01),抗结核治疗6个月末组IL12与对照组比较差异无显著性(P>0.05)。肺结核治疗6个月末组血清IL13显著高于治疗前和对照组(P<0.01,P<0.05)。结论对肺结核患者检测血清IL12和IL13水平有助于病情判断及疗效观察。     

老年肺结核患者血清血管活性肠肽的变化及临床意义

目的 探讨血管活性肠肽(VIP)在老年肺结核患者血清中的改变及与白细胞介素4(IL-4)、γ干扰素(IFN-γ)的相关性.方法 采用放射免疫分析(RIA)法检测40例老年活动性肺结核患者(老年活动性肺结核组)、30例老年非活动性肺结核患者(老年非活动性肺结核组)、30例中青年活动性肺结核患者(中青年活动性肺结核组)及20例老年健康人(健康组)血清VIP水平,酶联免疫吸附(ELISA)法检测血清IFN-γ、IL-4水平.老年活动性肺结核组中,病灶范围大或有空洞形成患者17例,病变范围小患者23例.结果 老年活动性肺结核组血清VIP、IL-4水平高于老年非活动性肺结核组及健康组(均P ＜0.01).老年活动性肺结核组IFN-γ水平低于健康组,差异有统计学意义(P＜0.05).病灶范围大或有空洞形成患者血清VIP、IL-4水平高于病变范围小患者(P＜0.05).老年活动性肺结核患者血清VIP、IL-4及IFN-γ水平与中青年活动性肺结核患者比较差异无统计学意义.老年活动性肺结核患者血清VIP与IL-4呈正相关(r=0.672,P＜0.01),与IFN-γ呈负相关(r=-0.406,P＜0.01).老年非活动性肺结核组、健康组血清VIP与IL-4、IFN-γ之间均无相关性.结论 VIP可能对评价老年肺结核病情严重程度、活动性以及判断其转归具有一定的参考意义.     

骨髓增生性疾病患者的血清TNFα及白细胞介素变化

采用ELISA法或RIA法对26例骨髓增生性疾病（MPD）患者的肿瘤坏死因子（TNFα）、白细胞介素2－及其受体（IL－2／sIL-2R)、白细胞介素6及其受体（IL－6／sIL-6R)和β2－MD水平进行了检测。发现MPD患者血清IL－2、β2－MG显著高于正常对照组,TNFα有升高趋势,IL－6／sIL-6R水平与对照组无显著性差异。病情活动或转化为急性白血病时,IL－2／sIL-2R和β2－MG均显著升高,提示这三项指标可作为判断MDP病情活动的参数。     

肾综合征出血热急性期外周血细胞因子的检测及其临床意义

目的 探讨肾综合征出血热（HFRS）患者急性期外周血肿瘤坏死因子－α（TNF－α），白细胞介素－2（IL－2），白细胞介素－6（IL－6），白细胞介素－8（IL－8）含量的变化及其临床意义。方法 应用酶联方法（ELISA）对34例肾综合征出血热患者急性期外周血细胞因子进行检测。结果 HFRS患者血清TNF－α，IL－6及IL－8水平均明显高于对照组，且含量随病情加重而升高，重型组明显高于中轻型组；患者的IL－2则低于对照组，重型组较中轻型组明显降低。结论 患者血中上升的TNF－α，IL－6及IL－8和下降的IL－2水平均与该病的病理损伤有关，且与病情轻重成正相关。     

慢性肝病患者血清TNF—α、IL—8和血浆选择素水平的检测及其意义

目的：探讨TNF－α、IL－8和P-selectin与慢性肝病的关系。方法应用双抗体夹心酶联免疫吸附法（ELISA）测定124例慢性肝病患者血清TNF－α、IL－8和P－selectin的水平。结果：慢性肝病患者血清TNF－α、IL－8和P－selectin水平均明显高于对照组（P值均＜0．001，P－selectin组P＜0．01）。结论TNF－α、IL－8和P－selctin可能与慢性肝病免疫病理损伤过程。检测血清TNF－α、IL－8和P－selectin水平对判断患者病情和预后有临床实用价值。     

类风湿关节炎患者血清肿瘤坏死因子α、白细胞介素-6的检测及其临床意义

目的：探讨类风湿关节炎（RA）患者血清瘤坏死因子（TNF）α、白细胞介素-6（IL6）水平变化及其临床意义。方法；应用酶联免疫吸附法（ELISA）检测RA患者治疗前后血清TNFα、IL－6水平，并与部分临床指标作相关性分析，结果：RA患者血清TNFα、IL－6水平明显高于正常对照组，且与部分临床指标是正相关，重度活动期RA患者TNFα、IL－6水平明显高于轻、中度活动期，治疗后随着病情好转，患者血清TNFα、IL－6水平有明显下降。结论：RA的发病与血清TNFα、IL－6介导的细胞免疫调节异常有着明显的关系。检则血清TNFα、IL－6水平对RA的病情活动观察、药物的选择具有重要的临床价值。     

Increased soluble tumor necrosis factor receptor levels in the serum of elderly people

BACKGROUND: Soluble (s) forms of tumor necrosis factor (TNF) receptors are the only natural molecules known to interfere with TNF activity by competing for TNF binding with receptors on target cells. In a variety of pathologic situations, the concentrations of sTNF receptors (R) increase. OBJECTIVE: To discuss possible causes of increased risks for infectious disease and cancer seen in the elderly. METHODS: The participants were healthy subjects (n = 48) of three age groups (young, middle-aged, and elderly). Patients with senile dementia of Alzheimer type (n = 25) were also studied. For detection of cytokines, interleukin (IL) 1alpha, IL-1beta, IL-6, macrophage colony-stimulating factor (M-CSF), granulocyte colony-stimulating factor, and TNF-alpha were measured in serum by enzyme-linked immunosorbent assays, as were soluble (s) IL-1 receptor antagonist (IL-1ra), sIL-6R, p55sTNF-R, and p75sTNF-R. RESULTS: IL-1alpha, IL-1beta, IL-6, and TNF-alpha were not detected, and sIL-6R and IL-1ra concentrations were not significantly different between the three age groups. However, sTNF-R and M-CSF were increased in sera from the elderly, both healthy and demented. A significant correlation was seen between sTNF-R and M-CSF concentrations. CONCLUSIONS: Increased sTNF-R levels may oppose the physiologic and protective effects of TNF by interference with its receptor binding. This interaction may contribute to the susceptibility of the elderly to infectious and neoplastic diseases.     

Serum concentration of interleukin 15, interleukin 2 receptor and TNF receptor in patients with polymyositis and dermatomyositis: correlation to disease activity

Cytokines are implied in polymyositis/dermatomyositis (PM/DM) pathogenesis. Our aim was to evaluate the serum levels of interleukin-15 (IL-15), soluble receptors for IL-2 (sIL-2R) and TNF-alpha type 1 receptor (sTNF-R1) in PM/DM patients and their relation to disease activity and clinical symptoms. Thirty-eight patients who met definite or probable criteria of Bohan and Peter for DM/PM were included into the study. Results in patients with active (41 observations) and inactive disease (24 observations) were compared with control (15 subjects). The median level of IL-15 was 47.6 ± 170 pg/ml in active patients, 25.15 ± 240 pg/ml in inactive and 28.5 ± 28.89 pg/ml in controls. We demonstrated significant differences between active patients and controls in levels of IL-15 (0.016, 95%CI 1.39–57.1). The median level of sIL-2R was 314 ± 388, 235.3 ± 269 and 144.3 ± 152.9 pg/ml, and the median level of sTNF-R1 was 350 ± 388; 294.7 ± 204.7; 209.5 ± 105.9 pg/ml in active, inactive and control subjects, respectively. There were significantly higher serum levels of these cytokines in active patients than in control subjects (for sIL-2R P = 0.05, CI95% 0.4–331; and sTNF-R1 P = 0.031, CI95% 15.1–321.5). The interleukin levels did not differ between inactive patients and controls. Elevation of IL-15, sIL2-R and sTNF-R1 in active patients provides preliminary evidence for the activation of inflammatory response during PM/DM flares. Further studies may be needed to explain the mechanisms driving these diseases.     

The tumor necrosis factor family and and correlation with disease activity and response to treatment in hairy cell leukemia

Hairy cell leukemia (HCL) is a well recognized indolent B-cell lymphoproliferative disorder. HCL cell proliferation is regulated by growth factors and cytokines, of which tumor necrosis factor-alpha (TNF-alpha) may be one of the most important. The mechanism of TNF-alpha-induced HCL cell growth is mediated via 2 receptors, which are present in both cellular and soluble forms. In this study we determined the serum levels of TNF-alpha and their soluble receptors - sTNF-R60 and sTNF-R80 - in 23 HCL patients and correlated them with clinical parameters before and after therapy. Patients were classified according to their clinical status as either "active" at diagnosis or during relapse and "non-active" (responding to therapy with partial and complete remission). Most patients were treated with 2-CDA, following which serum levels of TNF-alpha, sTNF-R60 and sTNF-R80 were significantly decreased, particularly in CR. Significant differences in paired observation values were noted for TNF-alpha and sTNF-R80, indicating a good correlation with the clinical status of disease, but this was not the case for sTNF-R60 (coefficients of correlation between levels of TNF-alpha and sTNF-R80 and of TNF-alpha and sTNF-R60 were r = 0.85 and r= 0.64, respectively). These results suggest that decreases in both TNF-alpha and sTNF-R80 are indicative of response to treatment, while increased levels accompany active disease. Accordingly, we conclude that serum levels of the TNF family, as for the sIL-2R and IL-1 family, may also be used as sensitive markers for monitoring HCL status. Levels may be indicative of the clinical efficacy of therapy and can be used as an indicator of the presence of residual disease.     

Serum concentrations of proinflammatory cytokines in Graves' disease: effect of treatment, thyroid function, ophthalmopathy and cigarette smoking

OBJECTIVE: In the present study we have measured the concentrations of interleukin-6 (IL-6), soluble IL-6 receptor (sIL-6R), tumor necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1 beta) and IL-1 receptor antagonist (IL-1Ra) in the serum of patients with Graves' disease (GD). By multivariate analysis, we have evaluated the effect of antithyroid treatment, thyroid function, the presence or absence of active thyroid-associated ophthalmopathy (TAO), the patient's smoking habits and the relation to circulating anti-thyrotropin (TSH) receptor (TRAb) and anti-thyroperoxidase antibodies (TPOAb). SUBJECTS: We studied 84 GD patients, 51 untreated and 33 receiving methimazole (MMI) therapy. Twenty-three (45%) untreated patients and 18 (54%) patients on MMI had active TAO. We also studied 67 normal subjects as controls. Thirty-one GD patients (43%) and 16 controls (36%) were smokers. RESULTS: Serum IL-6 concentrations were significantly higher in both untreated patients (P<0.001) and treated patients (P<0.006), when compared with controls. Serum sIL-6R concentrations were significantly affected by treatment (P=0.001). Serum IL-1Ra concentrations were not different in GD patients, whether treated or untreated, compared with controls. Serum IL-6 concentrations were not influenced by thyroid function and there was a significant interaction between treatment and the presence of active TAO (P=0.003). In hyperthyroid patients with active TAO serum, sIL-6R concentrations were significantly higher than in those with inactive TAO (P=0.003). In untreated GD patients there was no significant effect of thyroid function and TAO activity on the serum concentrations of TNF-alpha and IL-1 beta. Serum IL-1Ra concentrations were not affected by the presence of TAO. Smoking had no effect on serum IL-6, sIL-6R, TNF-alpha, IL-1 beta and IL-1Ra concentrations, even in the presence of an active TAO. Serum concentrations of IL-6, sIL-6R, TNF-alpha and IL-1 beta and IL-1Ra were not different in patients with and without TRAb or TPOAb, in relation to either thyroid function, TAO activity or smoking. CONCLUSIONS: Our work shows that: (i) the proinflammatory cytokine pattern in GD is greatly influenced by antithyroid drug treatment; (ii) the increased circulating IL-6/sIL-6R concentrations observed in patients with active TAO may derive from the activation of humoral reactions in sites other than the thyroid; and, (iii) cigarette smoking has no effect on serum IL-1/IL-1Ra concentrations in TAO.     

Soluble TNF-alpha receptor and IL-1 receptor antagonist elevation in BAL in active pulmonary TB.

Accumulating evidence suggests that patients with active pulmonary tuberculosis (TB) have an alveolar inflammation resulting in the release of tumour necrosis factor (TNF)-alpha and interleukin (IL)-1beta in bronchoalveolar epithelial fluid. It was proposed that the levels of these cytokines would correlate with clinical status parameters (extent of pulmonary involvement, fever, and body weight loss) and that their naturally occurring inhibitors would be concomitantly released in the local inflammatory sites. To test this hypothesis lung epithelial lining fluid (ELF) obtained by bronchoalveolar lavage and serum were collected from 29 patients with active pulmonary TB and 15 healthy subjects to determine the levels of these variables using a sandwich enzyme-linked immunosorbent assay (ELISA). ELF levels of TNF-alpha, soluble (s)TNF receptor I (RI), sTNF-receptor II (RII) and interleukin-1 receptor antagonist (IL-1RA) but not IL-1beta, and their serum levels except for sTNF-RII and IL-1beta were significantly higher in TB patients. Nevertheless, only ELF levels of TNF-alpha and IL-1beta were significantly correlated with disease status. No correlation was found between TNF-alpha levels and those of sTNF-RI and sTNF-RII, nor between IL-1beta and IL-1RA in ELF and serum of TB patients, although there was a significant correlation between sTNF-RI and sTNF-RII levels both in ELF and serum. These findings suggest local release of tumour necrosis factor-alpha and interleukin-1beta and a correlation with disease status. Soluble tumour necrosis factor-alpha receptors and interleukin-1beta receptor antagonist, although increased in lung epithelial lining fluid and serum in tuberculosis patients, were not correlated with tumour necrosis factor-alpha and interleukin-1beta or with disease status.     

Serum cytokine profiles in patients with adult onset Still's disease

OBJECTIVE: Adult onset Still's disease (AOSD) is a systemic inflammatory disorder characterized by fever, arthritis, and rash. Although the pathogenesis is not known, immunologically mediated inflammation occurs in active AOSD. To evaluate the pathogenesis and disease activity of AOSD, we measured serial serum concentrations of several cytokines in patients with active and inactive disease. METHODS: Seventeen patients diagnosed as having AOSD were enrolled. We analyzed clinical and laboratory findings retrospectively. Serial serum samples were obtained from 14 patients with active and inactive AOSD. Interleukin 18 (IL-18), soluble IL-2 receptor (sIL-2R), IL-6, interferon-g (IFN-g), and IL-8 were determined by ELISA. RESULTS: Serum levels of IL-18, IFN-g, and IL-8 were significantly higher in patients with AOSD than in healthy controls (p < 0.01), but there were no significant differences between patients with active and inactive AOSD. Serum sIL-2R levels tended to be higher in the active state than in healthy controls, but there was no statistically significant difference between the 2 groups. Serum sIL-2R levels decreased significantly with antiinflammatory therapy (p < 0.05). Serum IL-18 and sIL-2R levels correlated significantly with serum ferritin levels in the active AOSD group (p < 0.05). CONCLUSION: Overproduction of IL-18 may contribute to the pathogenic mechanism of AOSD, and serum sIL-2R levels may be used as a marker for monitoring disease activity in AOSD.     

Effect of beta-blockers on circulating levels of inflammatory and anti-inflammatory cytokines in patients with dilated cardiomyopathy

OBJECTIVES: This study was designed to evaluate the beneficial effect of beta-blockers on circulating cytokine levels in patients with dilated cardiomyopathy (DCM). BACKGROUND: Elevated circulating levels of inflammatory cytokines have been reported in patients with DCM. However, alterations of the levels of inflammatory and anti-inflammatory cytokines in association with beta-blocker therapy are unknown. METHODS: We studied 32 patients with idiopathic DCM who had been treated with digitalis, diuretics and angiotensin-converting enzyme inhibitors. In addition to this combination therapy, beta-blockers were started in all patients. Serum levels of interleukin (IL)-10, tumor necrosis factor-alpha (TNF-alpha) and soluble TNF receptors (sTNF-R1 and R2) were measured at baseline and 12 weeks after the initiation of beta-blocker therapy. We also measured plasma levels of neurohumoral factors, as well as left ventricular (LV) size and function. Ten age-matched subjects with no cardiac disease served as the control group. RESULTS: Baseline levels of IL-10, TNF-alpha and sTNF-R2 were significantly higher in patients with DCM than in control subjects (p < 0.05). There was a significant positive correlation between IL-10 and TNF-alpha levels (r = 0.545, p = 0.029). The TNF-alpha/IL-10 ratio correlated well with plasma epinephrine levels (r = 0.677, p = 0.025), and the level of sTNF-R2 was closely related to LV size. Serum levels of IL-10, TNF-alpha and sTNF-R2 were significantly decreased during beta-blocker therapy (p < 0.005). CONCLUSIONS: Our findings indicate that beta-blockers have an important immunoregulatory role in modifying the dysregulated cytokine network in DCM. This effect of beta-blockers may be partly responsible for the efficacy of therapeutic drugs for heart failure.     

Increased expression of IL-12 receptor mRNA in active pulmonary tuberculosis and sarcoidosis.

Cytokines have been implicated in the pathophysiology and development of pulmonary diseases such as tuberculosis and sarcoidosis. In particular, the numbers of cells expressing Th1-type cytokines such as IFN-gamma and IL-12 are increased within the lungs of patients with these granulomatous diseases. As a factor promoting the commitment of naive lymphocytes to a Th1-type profile of cytokine expression, IL-12 may be pivotal in the cascade of proinflammatory events within the airways. In this study, we examined the expression of the IL-12 receptor (IL-12R) mRNA in bronchoalveolar lavage (BAL) fluid from patients with active pulmonary tuberculosis (n = 6) and active pulmonary sarcoidosis (n = 6), and from allergic asthmatics (n = 6) and normal control subjects (n = 6). Bronchoscopy with BAL was undertaken, and cell cytospins were examined using the technique of in situ hybridization. There was a significant increase in the numbers of cells expressing mRNA for both beta(1) and beta(2) subunits of the IL-12R in active pulmonary sarcoidosis (p < 0.02, p < 0.01, respectively) and active pulmonary tuberculosis (p < 0.01, p < 0.005, respectively) compared with normal control subjects. In contrast, the allergic asthmatic patients exhibited a significant decrease in the number of IL-12R mRNA-positive cells (both beta(1) and beta(2) subunits (p < 0.01, p < 0.005, respectively), compared with the normal control subjects. These patients did, however, exhibit a significant increase in IL-4R mRNA, which was not evident in those with either tuberculosis or sarcoidosis when compared with normal subjects (p < 0.05). Colocalization studies demonstrated that CD8+ve cells are a principal site for the expression of IL-12R in tuberculosis. In sarcoidosis, IL-12R was expressed both on CD4+ve and CD8+ve cells. The increased expression of receptors for IL-12 in granulomatous diseases such as pulmonary tuberculosis and sarcoidosis provides evidence supporting the commitment of lymphocytes to a Th1-type cytokine profile in vivo.     

Serum and ascites fluid cytokine levels in patients with chronic heart failure

OBJECTIVE: Cytokines that are capable of modulating cardiovascular function were reported to be elevated in patients with advanced heart failure. We evaluated the diagnostic importance of cytokines both in the serum and ascites. MATERIAL AND METHODS: We determined serum and ascites fluid TNF-alpha, IL-1beta, IL-6, IL-8, and soluble IL-2 receptor levels in 14 patients with congestive heart failure (group 1) and in 15 patients with chronic liver disease (group 2). RESULTS: Ascites fluid IL-8 and soluble IL-2 receptor levels were found to be significantly elevated in group 1 when compared with group 2 (p = 0.014 and p = 0.005). There were no statistical differences in serum TNF-alpha, IL-1beta, IL-6, IL-8, and soluble IL-2 receptor levels and ascites fluid TNF-alpha, IL-1beta, and IL-6 levels. Ascites fluid/serum IL-1beta and IL-8 ratio was lower in group 1 when compared with group 2 (p = 0.001 and p = 0.005). Ascites fluid/serum IL-2 and IL-6 ratio was higher in group 1 when compared with group 2 (p = 0.035 and p = 0.025). CONCLUSION: Cytokine levels in ascites fluid, but not in serum, are important in congestive heart failure. Ascites fluid/serum cytokine level ratios were detected to be more conclusive and valid in the diagnosis work-up of ascites aetiology.