Cytokines regulation of chronic inflammation

Interleukin-18 (IL-18), a recently described member of the IL-1 cytokine family, is now recognized as an important regulator of innate and acquired immune responses. IL-18 is a mediator of inflammation and ischemic tissue injury in many organs. IL-18 is con-stitutively expressed by intercalated cells of the late distal convoluted tubule, fhe connecting tubule, and the collecting duct of the healthy human kidney [229]. It is expressed at sites of chronic inflammation, in autoimmune diseases, in a variety of cancers, and in the... 

Many cytokines have been implicated in the pathophysiolc of asthma (Arai etal., 1990 Cluzel and Lee, 1992). Cytokines are important in the production of immunoglobulin E (IgE), in the regulation of cellular infiltration of the airways, in the activation of inflammatory and resident cells, and in producing the structural changes that are a consequence of chronic inflammation. 

Anemia may be present in some patients due to impaired erythropoietin regulation, nutritional factors (vitamin E and iron malabsorption), or chronic inflammation. With chronic pulmonary disease, increased cytokine production can lead to shortened red blood cell survival, reduced erythropoietin response, and impaired mobilization of iron stores. 

It has been well documented that the anaemia of chronic disease, ACD, results in a lowering of various haematological parameters. Several mediators are involved, among them histamine, serotonin, bradykinin, prostaglandins and, as found more recently, cytokines and nitric oxide. ACD is a parameter of systemic autoimmune disorders. The severe inflammatory stimuli lead to several systemic changes, mediated by inflammation-associated cytokines, e.g. IL-6, IL-1 TNFa, TGF beta that regulate hepatic synthesis of the acute phase proteins. 

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