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The role of interleukin 6 in the pathogenesis of hyponatremia associated with Guillain-Barré syndrome
Se Jin Parka, Ki Soo Paia, Ji Hong Kimb, Jae II Shinb
a Department of Pediatrics, Ajou University School of Medicine, Ajou University, Suwon, Korea,
b Department of Pediatrics, Yonsei University College of Medicine, Severance Children¿s Hospital, Seoul, Korea,
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    "textoCompleto" => "<p class="elsevierStylePara"><span class="elsevierStyleBold">Dear&#160;Editor&#44;</span></p><p class="elsevierStylePara">We read with great interest the contribution by Monz&#243;n et al&#46;<span class="elsevierStyleSup">1</span> They reported a significant case of a man who had Guillain-Barr&#233; syndrome &#40;GBS&#41; with syndrome of inappropriate antidiuretic hormone &#40;SIADH&#41; and speculated that increased sensitivity to vasopressin in the renal tubule and a long-lasting hypo-osmolarity or antidiuretic substances might cause GBS-related SIADH&#46; However&#44; we would like to add a possible pathomechanism in the development of hyponatremia associated with GBS&#46;</p><p class="elsevierStylePara">According to a previous study by Maimone et al&#46;&#44;<span class="elsevierStyleSup">2</span> interleukin &#40;IL&#41;-6&#44; a multifunctional cytokine&#44; might be implicated in the immunopathogenesis of GBS&#46; In their study&#44; serum IL-6 levels were increased in six &#40;26&#37;&#41; of 23 GBS patients&#44; and detectable levels of IL-6 were also found in the cerebrospinal fluid in 13 &#40;57&#37;&#41;&#46;<span class="elsevierStyleSup">2</span> Using enzyme-linked immunospot assays&#44; Press et al&#46;<span class="elsevierStyleSup">3</span> found elevated numbers of IL-6-secreting blood mononuclear cells during the acute phase in patients with GBS&#46;</p><p class="elsevierStylePara">Quite recently and importantly&#44; Swart et al&#46;<span class="elsevierStyleSup">4</span> depicted the cascade-like fashion of events initiated by an inflammatory stimulus &#40;lipopolysaccharides&#41;&#44; with tumor necrosis factor-&#945; secreted first&#44; IL-1&#946; second&#44; and IL-6 last&#44; suggesting possible pathways connecting IL-6 to vasopressin release&#46; These pro-inflammatory cytokines are secreted into the systemic circulation to initiate the acute phase response which is involved in the innate immune system&#46;<span class="elsevierStyleSup">5</span></p><p class="elsevierStylePara">Furthermore&#44; Mastorakos et al&#46;<span class="elsevierStyleSup">6</span> reported that plasma antidiuretic hormone levels were elevated after IL-6 injection in cancer patients&#44; suggesting that IL-6 activated the magnocellular ADH-secreting neurons and that it might be involved in SIADH&#46; Activation of the subfornical organ and the organum vasculosum of the lamina terminalis by IL-6 could eventually lead to thirst and increased vasopressin secretion by neurons from the supraoptic nucleus and paraventricular nucleus&#46;<span class="elsevierStyleSup">4</span> The combination of antidiuresis and increased water intake may result in hyponatremia&#46;</p><p class="elsevierStylePara">Therefore&#44; there is a possibility that IL-6 may play a central role in the pathogenesis of hyponatremia associated with GBS&#46; However&#44; further studies are necessary to elucidate if IL-6 crosses the blood-brain barrier &#40;BBB&#41;&#44; or whether lipopolysaccharides crosse the BBB and then increases IL-6 locally in the brain in the future&#46;</p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Conflict of interest</span></p><p class="elsevierStylePara">The authors declare they have no potential conflicts of interest related to the contents of this article&#46;</p>"
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ISSN: 20132514
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2017 March 33 33 66
2017 February 22 6 28
2017 January 22 5 27
2016 December 30 2 32
2016 November 40 4 44
2016 October 44 15 59
2016 September 72 3 75
2016 August 162 5 167
2016 July 151 5 156
2016 June 105 0 105
2016 May 103 0 103
2016 April 66 0 66
2016 March 56 0 56
2016 February 70 0 70
2016 January 84 0 84
2015 December 101 0 101
2015 November 64 0 64
2015 October 82 0 82
2015 September 56 0 56
2015 August 58 0 58
2015 July 51 0 51
2015 June 32 0 32
2015 May 34 0 34
2015 April 5 0 5
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Idiomas
Nefrología (English Edition)