Correlation between transcranial interleukin-6 gradient and outcome in patients with acute brain injury

Abstract

IL-6 is elevated in patients with acute brain injury, and a significant relationship exits between the severity of acute brain injury and the transcranial IL-6 gradient at admission. It can be considered to be a prognosis marker at admission. When data at the moment of brain death are considered, venous IL-6 (p <.01) and the transcranial IL-6 gradient (p <.005) are significantly higher than at the time of admission. Although the IL-6 C allele is associated with significantly lower concentrations of IL-6, there was no correlation between low or high IL-6 responders and patient outcome.

Biomarkers for the Diagnosis, Prognosis, and Evaluation of Treatment Efficacy for Traumatic Brain Injury

“…The CSF levels of IL-6 reach a maximum between days 3 and 6 in TBI subjects, 56 with the severity of injury being related to the degree of intracranial IL-6 gradient (venous to arterial ratio) at the time of admission. 57 An in vivo microdialysis study has shown that increased parenchymal IL-6 levels correlate with survival and GOS suggesting that IL-6 is an endogenous neuroprotective cytokine. 58 Furthermore, increased CSF levels of IL-6 have been reported to correlate with improved outcome in pediatric TBI.…”

Temporal Profile of Cerebrospinal Fluid, Plasma, and Brain Interleukin-6 After Normothermic Fluid-Percussion Brain Injury: Effect of Secondary Hypoxia

“…IL-6 production has also been demonstrated clinically, with ventricular CSF and plasma levels being elevated for days following TBI (McClain et al, 1991;Kossmann et al, 1995Kossmann et al, , 1996Aibiki et al, 1999;Csuka et al, 1999;Volkmar et al, 1999;Schwerdtfeger et al, 2001;Singhal et al, 2002;Winter et al, 2002;Buttram et al, 2007). Recent experimental and clinical studies have reported a positive correlation between IL-6 levels and injury severity and prognosis (Tarkowski et al, 1995;Juttler et al, 2002;Woiciechowsky et al, 2002;Minambres, et al, 2003;Frugier et al, 2010;Leyet et al, 2011).…”

Traumatic Brain Injury and Inflammation: Emerging Role of Innate and Adaptive Immunity

“…Elevated levels of IL-6 were observed in the cerebrospinal fluid (CSF) and in the serum of patients with TBI and this increase was correlated with a favorable neurological outcome (Singhal et al, 2002;Chiaretti et al, 2008). In contrast, other studies demonstrated that IL-6 levels were correlated to the clinical severity of TBI patients (Arand et al, 2001;Minambres et al, 2003). Studies in animal models provide evidence for a neuroprotective effect of IL-6.…”