Plasma cytokines IL-6, IL-8, and IL-10 are associated with the development of acute respiratory distress syndrome in patients with severe traumatic brain injury

Imo P Aisiku, Jose-Miguel Yamal, Pratik Doshi, Julia S Benoit, Shankar Gopinath, Jerry C Goodman, Claudia S Robertson, Imo P Aisiku, Jose-Miguel Yamal, Pratik Doshi, Julia S Benoit, Shankar Gopinath, Jerry C Goodman, Claudia S Robertson

Abstract

Background: Patients with severe traumatic brain injury (TBI) are at risk of the development of acute respiratory distress syndrome (ARDS). TBI and ARDS pathophysiologic mechanisms are known to independently involve significant inflammatory responses. The literature on the association between plasma inflammatory cytokines and ARDS in patients with TBI is sparse.

Methods: The study was a secondary analysis of the safety of a randomized trial of erythropoietin and transfusion threshold in patients with severe TBI. Inflammatory markers within the first 24 hours after injury were compared in patients who developed ARDS and patients without ARDS, using Cox proportional hazards models.

Results: There were 200 patients enrolled in the study. The majority of plasma and cerebrospinal fluid (CSF) cytokine levels were obtained within 6 hours. Plasma proinflammatory markers IL-6 and IL-8 and anti-inflammatory marker IL-10 were associated with the development of ARDS (adjusted hazard ratio (HR) = 1.55, confidence interval (CI) = 1.14, 2.11, P = 0.005 for IL-6; adjusted HR = 1.32, CI = 1.10, 1.59, P = 0.003 for IL-8).

Conclusion: Plasma markers of IL-6, IL-8, and IL-10 are associated with ARDS in patients with severe TBI.

Trial registration: NCT00313716 registered 4/2006.

Keywords: ALI; ARDS; CSF; Cytokines; Plasma; TBI.

Figures

Fig. 1
Fig. 1
a Distribution of time of plasma cytokine measurement after injury. b Distribution of time of cerebrospinal fluid cytokine measurement after injury

References

    1. Kadhim HJ, Duchateau J, Sebire G. Cytokines and brain injury: invited review. J Intensive Care Med. 2008;23(4):236–49. doi: 10.1177/0885066608318458.
    1. Soriano SG, Piva S. Central nervous system inflammation. Eur J Anaesthesiol Suppl. 2008;42:154–9. doi: 10.1017/S0265021507003390.
    1. Engelhardt B. Immune cell entry into the central nervous system: involvement of adhesion molecules and chemokines. J Neurol Sci. 2008;274(1-2):23–6. doi: 10.1016/j.jns.2008.05.019.
    1. Schneider Soares FM, Menezes de Souza N, Liborio Schwarzbold M, et al. Interleukin-10 is an independent biomarker of severe traumatic brain injury prognosis. Neuroimmunomodulation. 2012;19(6):377–85. doi: 10.1159/000342141.
    1. Lu J, Goh SJ, Tng PY, Deng YY, Ling EA, Moochhala S. Systemic inflammatory response following acute traumatic brain injury. Front Biosci. 2009;14:3795–813. doi: 10.2741/3489.
    1. Gullo Jda S, Bertotti MM, Silva CC, et al. Hospital mortality of patients with severe traumatic brain injury is associated with serum PTX3 levels. Neurocrit Care. 2011;14(2):194–9. doi: 10.1007/s12028-010-9462-y.
    1. Schwarzbold ML, Rial D, De Bem T, et al. Effects of traumatic brain injury of different severities on emotional, cognitive, and oxidative stress-related parameters in mice. J Neurotrauma. 2010;27(10):1883–93. doi: 10.1089/neu.2010.1318.
    1. D’Mello C, Le T, Swain MG. Cerebral microglia recruit monocytes into the brain in response to tumor necrosis factor alpha signaling during peripheral organ inflammation. J Neurosci. 2009;29(7):2089–102. doi: 10.1523/JNEUROSCI.3567-08.2009.
    1. Goodman JC, Van M, Gopinath SP, Robertson CS. Pro-inflammatory and pro-apoptotic elements of the neuroinflammatory response are activated in traumatic brain injury. Acta Neurochir Suppl. 2008;102:437–9. doi: 10.1007/978-3-211-85578-2_85.
    1. Hergenroeder GW, Moore AN, McCoy JP, Jr, et al. Serum IL-6: a candidate biomarker for intracranial pressure elevation following isolated traumatic brain injury. J Neuroinflammation. 2010;7:19. doi: 10.1186/1742-2094-7-19.
    1. Siler TM, Swierkosz JE, Hyers TM, Fowler AA, Webster RO. Immunoreactive interleukin-1 in bronchoalveolar lavage fluid of high-risk patients and patients with the adult respiratory distress syndrome. Exp Lung Res. 1989;15(6):881–94. doi: 10.3109/01902148909069633.
    1. Schutte H, Lohmeyer J, Rosseau S, et al. Bronchoalveolar and systemic cytokine profiles in patients with ARDS, severe pneumonia and cardiogenic pulmonary oedema. Eur Respir J. 1996;9(9):1858–67. doi: 10.1183/09031936.96.09091858.
    1. Suter PM, Suter S, Girardin E, Roux-Lombard P, Grau GE, Dayer JM. High bronchoalveolar levels of tumor necrosis factor and its inhibitors, interleukin-1, interferon, and elastase, in patients with adult respiratory distress syndrome after trauma, shock, or sepsis. Am Rev Respir Dis. 1992;145(5):1016–22. doi: 10.1164/ajrccm/145.5.1016.
    1. Park WY, Goodman RB, Steinberg KP, et al. Cytokine balance in the lungs of patients with acute respiratory distress syndrome. Am J Respir Crit Care Med. 2001;164(10 Pt 1):1896–903. doi: 10.1164/ajrccm.164.10.2104013.
    1. Donnelly SC, Strieter RM, Reid PT, et al. The association between mortality rates and decreased concentrations of interleukin-10 and interleukin-1 receptor antagonist in the lung fluids of patients with the adult respiratory distress syndrome. Ann Intern Med. 1996;125(3):191–6. doi: 10.7326/0003-4819-125-3-199608010-00005.
    1. Pittet JF, Mackersie RC, Martin TR, Matthay MA. Biological markers of acute lung injury: prognostic and pathogenetic significance. Am J Respir Crit Care Med. 1997;155(4):1187–205. doi: 10.1164/ajrccm.155.4.9105054.
    1. Parsons PE, Moss M, Vannice JL, Moore EE, Moore FA, Repine JE. Circulating IL-1ra and IL-10 levels are increased but do not predict the development of acute respiratory distress syndrome in at-risk patients. Am J Respir Crit Care Med. 1997;155(4):1469–73. doi: 10.1164/ajrccm.155.4.9105096.
    1. Maier S, Emmanuilidis K, Entleutner M, et al. Massive chemokine transcription in acute renal failure due to polymicrobial sepsis. Shock. 2000;14(2):187–92. doi: 10.1097/00024382-200014020-00019.
    1. Donnelly SC, Strieter RM, Kunkel SL, et al. Interleukin-8 and development of adult respiratory distress syndrome in at-risk patient groups. Lancet. 1993;341(8846):643–7. doi: 10.1016/0140-6736(93)90416-E.
    1. Goris RJ. Mediators of multiple organ failure. Intensive Care Med. 1990;16(Suppl 3):S192–6. doi: 10.1007/BF01709699.
    1. Force ADT, Ranieri VM, Rubenfeld GD, et al. Acute respiratory distress syndrome: the Berlin definition. JAMA. 2012;307(23):2526–33.
    1. Robertson CS, Hannay HJ, Yamal JM, et al. Effect of erythropoietin and transfusion threshold on neurological recovery after traumatic brain injury: a randomized clinical trial. JAMA. 2014;312(1):36–47. doi: 10.1001/jama.2014.6490.
    1. Tibshirani R. The lasso method for variable selection in the Cox model. Stat Med. 1997;16(4):385–95. doi: 10.1002/(SICI)1097-0258(19970228)16:4<385::AID-SIM380>;2-3.
    1. Morganti-Kossmann MC, Rancan M, Stahel PF, Kossmann T. Inflammatory response in acute traumatic brain injury: a double-edged sword. Curr Opin Crit Care. 2002;8(2):101–5. doi: 10.1097/00075198-200204000-00002.
    1. Whitney NP, Eidem TM, Peng H, Huang Y, Zheng JC. Inflammation mediates varying effects in neurogenesis: relevance to the pathogenesis of brain injury and neurodegenerative disorders. J Neurochem. 2009;108(6):1343–59. doi: 10.1111/j.1471-4159.2009.05886.x.
    1. Ruff RM, Marshall LF, Crouch J, et al. Predictors of outcome following severe head trauma: follow-up data from the Traumatic Coma Data Bank. Brain Inj. 1993;7(2):101–11. doi: 10.3109/02699059309008164.
    1. Gattinoni L, Protti A, Caironi P, Carlesso E. Ventilator-induced lung injury: the anatomical and physiological framework. Crit Care Med. 2010;38(10 Suppl):S539–48. doi: 10.1097/CCM.0b013e3181f1fcf7.
    1. Kuchnicka K, Maciejewski D. Ventilator-associated lung injury. Anaesthesiology Interv Ther. 2013;45(3):164–70. doi: 10.5603/AIT.2013.0034.
    1. The Acute Respiratory Distress Syndrome Network Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med. 2000;342(18):1301–8. doi: 10.1056/NEJM200005043421801.

Source: PubMed

Patrocinadores e Colaboradores

Condições médicas

Intervenções de drogas

3
Se inscrever