The Soluble Interleukin-2 Receptor: Biology, Function, and Clinical Application

  1. Laurence A. Rubin, MD; and
  2. David L. Nelson, MD

    Abstract

    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.

    Article and Author Information

    • From the University of Toronto and Sunnybrook Health Science Centre, Toronto, Ontario; and the National Cancer Institute, the National Institutes of Health, Bethesda, Maryland. For current author addresses, see end of text.

    • Drs. Rubin, Nelson and colleagues are named as inventors on a patent for the measurement of soluble interleukin-2 receptors, which has been assigned to the Government of the United States of America. Drs. Rubin and Nelson have no financial, consultative or other specific relations with those companies that produce and market the soluble IL-2R ELISA under license from the U.S. government.

    • Grant Support: In part by the Arthritis Society of Canada, the Heart and Stroke Foundation, and the Medical Research Council of Canada.

    • Requests for Reprints: Laurence A. Rubin, MD, University of Toronto, Medical Sciences Building, Room 5242, Toronto, Ontario M5S 1A8.

    • Current Author Addresses: Dr. Rubin: University of Toronto, Medical Sciences Building, Room 5242, Toronto, Ontario M5S 1A8. Dr. Nelson: Building 10, Room 4N115, National Institutes of Health, Bethesda, MD 20892.

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    1. Ann Intern Med October 15, 1990 vol. 113 no. 8 619-627
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