[Interleukin-6 (IL-6), soluble interleukin-2-receptor (sIL-2R) and microheterogeneity of alpha-! acid glycoprotein (AGP): new markers of the acute-phase reaction?].

Cytokines and the different glycosylation profiles of some acute phase proteins appear to be of great value in investigating the activity of inflammatory rheumatic diseases. Using an ELISA to measure the serum concentration of sIL-2R and IL-6 and an affinity electrophoresis with Concanavalin A as a lectin to determine the microheterogenity of the alpha-1-acid-glycoprotein (AGP), we tested the sera of 63 patients with various rheumatic and infectious diseases and 17 healthy persons and compared the results with the usual markers of inflammation, e.g. erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), and with the clinical activity of the disease. ESR, CRP and sIL-2R were significantly elevated (p less than 0.001) in seropositive rheumatoid arthritis (RA) and in acute bacterial infection. ESR and CRP showed a better correlation with the clinical activity of RA than sIL-2R. Marked elevation of IL-6 was found only in 30% of RA patients in the early stage of the acute phase reaction (APR). The AGP reactivity coefficient (AGP-RC) was significantly decreased in RA (p less than 0.01) but increased in bacterial infections (p less than 0.001). Our results show that there is no advantage in measuring sIL-2R in the routine diagnosis of rheumatic diseases. Raised IL-6 levels seem to indicate an early stage of APR. If ESR and CRP are elevated, the AGP-RC helps to differentiate between infection and chronic inflammatory rheumatic diseases.