Interleukin-10 Is an Independent Biomarker of Severe Traumatic Brain Injury Prognosis

Abstract

Background: Cytokines have been shown to be involved in traumatic brain injury (TBI). We investigated the independent association between serum levels of IL-10 and TNF-α and hospital mortality of patients with severe TBI. Methods: Serum IL-10 and TNF-α levels were determined after a median period (interquartile range (IQ) 25–75) of 10 h (IQ 5–18) after severe TBI in 93 consecutive patients and in randomly selected patients with mild (n = 18) and moderate (n = 16) TBI. In patients with severe TBI, additional blood samples were analyzed 30 h (IQ 22–37) and 68 h (IQ 55–78) after TBI. Age, gender, computed tomography findings, Glasgow Coma Scale score (GCS) and pupil reactions at admission, associated trauma and hospital mortality were collected. Results: Elevated serum levels of IL-10, but not TNF-α, correlated significantly with GCS severity (R² coefficient, p < 0.0001) and were found to be associated with hospital mortality in patients with severe TBI. Elevated IL-10 remained associated with mortality (p = 0.01) in a subset of patients with isolated severe TBI (n = 74). Multiple logistic regression analysis showed that higher IL-10 levels (>90 pg/ml) at 10 or 30 h after TBI were 6 times (odds ratio (OR) 6.2, 95% confidence interval (CI) 1.2–25.1, p = 0.03) and 5 times (OR 5.4, 95% CI 1.2–25.1, p = 0.03), respectively, more frequently associated with hospital mortality than lower levels (<50 pg/ml), independently of age, GCS as well as pupil reactions at admission and associated trauma. Conclusions: Serum IL-10 levels may be a useful marker for severe TBI prognosis.

Emerging Roles for the Immune System in Traumatic Brain Injury

“…Interleukin-10 has been shown to be elevated in TBI patients (78, 133–135) and has been associated with unfavorable outcome and mortality (75, 134, 135). Despite these associations, Chen et al found a role for IL-10 in conferring neuroprotection with hyperbaric oxygen (HBO) treatment (80).…”

Role of hormonal levels on hospital mortality for male patients with severe traumatic brain injury

“…Statistical models which combine two or more variables of patient data to predict clinical outcome (also called prognostic models) have been applied to TBI research [5,6,28,29]. The investigation associated with prognosis may help in medical decisions, as well as identifying possible therapeutic targets for the patients [30][31][32]. The association between hormones and TBI prognosis can be affected by several confounding variables in the context of critically ill patients.…”

End Points of Traumatic Brain Injury Resuscitation

“…A prospective single-center study of 93 patients with GCS<9 following TBI found interleukin-10 (IL-10) to be an independent predictor of severe TBI prognosis. Elevated serum IL-10 correlated significantly with GCS severity and with hospital mortality in patients with severe TBI [42].…”