Inflammation biomarkers IL‑6 and IL‑10 may improve the diagnostic and prognostic accuracy of currently authorized traumatic brain injury tools

Abstract

Traumatic brain injury (TBI) is currently one of the leading causes of mortality and disability worldwide. At present, no reliable inflammatory or specific molecular neurobiomarker exists in any of the standard models proposed for TBI classification or prognostication. Therefore, the present study was designed to assess the value of a group of inflammatory mediators for evaluating acute TBI, in combination with clinical, laboratory and radiological indices and prognostic clinical scales. In the present single-centre, prospective observational study, 109 adult patients with TBI, 20 adult healthy controls and a pilot group of 17 paediatric patients with TBI from a Neurosurgical Department and two intensive care units of University General Hospital of Heraklion, Greece were recruited. Blood measurements using the ELISA method, of cytokines IL-6, IL-8 and IL-10, ubiquitin C-terminal hydrolase L1 (UCH-L1) and glial fibrillary acidic protein, were performed. Compared with those in healthy control individuals, elevated IL-6 and IL-10 but reduced levels of IL-8 were found on day 1 in adult patients with TBI. In terms of TBI severity classifications, higher levels of IL-6 (P= 0.001) and IL-10 (P=0.009) on day 1 in the adult group were found to be associated with more severe TBI according to widely used clinical and functional scales. Moreover, elevated IL-6 and IL-10 in adults were found to be associated with more serious brain imaging findings (r s <0.442; P<0.007). Subsequent multivariate logistic regression analysis in adults revealed that early-measured (day 1) IL-6 [odds ratio (OR)=0.987; P=0.025] and UCH-L1 (OR=0.993; P=0.032) are significant independent predictors of an unfavourable outcome. In conclusion, results from the present study suggest that inflammatory molecular biomarkers may prove to be valuable diagnostic and prognostic tools for TBI.

Multiplexed Quantitative Proteomics Reveals Proteomic Alterations in Two Rodent Traumatic Brain Injury Models

“…Several inflammatory responses are activated primarily in day 1 WD mice, as evidenced by positive activation scores for the fibroblast growth factors (FGF) pathway (activation prediction Z-score = 1.9, respectively) and the interleukin pathways. Several previous publications have reported brain inflammation following TBI, 75−78 with increased expression of IL-1-β, 79 IL-6, 80 IL-10, 81 and IL-17, 82 thereby activating downstream interleukin pathways. Our bioinformatics results are consistent with the IL-induced brain inflammation resulting from TBI.…”

Pathophysiology-Based Management of Secondary Injuries and Insults in TBI

“…A trophic factor that is upregulated in the CNS after injury and promotes neuronal survival and brain repair through astroglia and vascular remodelling. Following TBI, its concentration rises dramatically [60,61].…”

Fluid-Based Protein Biomarkers in Traumatic Brain Injury: The View from the Bedside

“…This process, if uncontrolled, can develop into a chronic inflammatory process [80,[82][83][84]. Circulating inflammatory molecules represent the group of fluid-based protein biomarkers that can be called "mechanistic markers", i.e., markers of specific pathobiological processes [1,129]. IL-8, activated by MMP9, is a proinflammatory and angiogenic signaling molecule; CXCL12, activated by HMGB1, is an inflammatory and angiogenic signaling molecule.…”