Serum interleukin-10 in ICU patients with severe acute central nervous system injuries

Dziurdzik, Piotr; Krawczyk, Lech; Jałowiecki, Przemysław; Kondera-Anasz, Zdzisława; Menon, Latha

doi:10.1007/s00011-004-1265-1

Cited by 23 publications

(34 citation statements)

References 20 publications

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“…41 However, serum levels are thought to increase in response to a variety of insults and are not specific to TBI. 28,63 In this study, we failed to demonstrate any association between IL-10 levels and outcome or markers of disease severity.…”

Section: Discussioncontrasting

confidence: 73%

Relationship of Serum and Cerebrospinal Fluid Biomarkers With Intracranial Hypertension and Cerebral Hypoperfusion After Severe Traumatic Brain Injury

Stein

Lindell

Murdock

et al. 2011

Journal of Trauma: Injury, Infection &Amp; Critical Care

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IL-8 and, to a lesser extent, TNF-α demonstrated the most promise in this study to be candidate serum markers of impending ICH and CH. The clinical relevance of this is the suggestion that we may be able to predict impending secondary insults after TBI before the clinical manifestation of these events. Given the known morbidity of ICH and CH, early intervention and prevention may have a significant impact on outcome. This becomes even more important when decisions must be made about timing of interventions. Increased levels of IL-8 and TNF-α in the serum during episodes of ICH and CH imply there are significant systemic effects of these events. These serum biomarkers are promising as diagnostic targets. In addition, further study of the precise role of these molecules may have significant implications for inflammatory system manipulation in the management of severe TBI.

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Section: Discussioncontrasting

confidence: 73%

Relationship of Serum and Cerebrospinal Fluid Biomarkers With Intracranial Hypertension and Cerebral Hypoperfusion After Severe Traumatic Brain Injury

Stein

Lindell

Murdock

et al. 2011

Journal of Trauma: Injury, Infection &Amp; Critical Care

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“…In contrast, initially high circulating levels of the proinflammatory cytokines IL-6 and monocyte chemotactic protein 1 (MCP1) and the main antiinflammatory cytokine IL-10 decreased over time. Serum levels of IL-5 and IL-8 were higher in nonsurvivors than in survivors, whereas both too-low and too-high levels of IL-6 as well as IL-10 were associated with a higher risk of organ failure and death (37)(38)(39). This U-shaped relationship is in agreement with the deleterious consequences of both the overwhelming proinflammatory response and the prolonged periods of immune suppression present in critical illness (reviewed in ref.…”

Section: Figuresupporting

confidence: 56%

Intensive insulin therapy protects the endothelium of critically ill patients

Langouche

Vanhorebeek²,

Vlasselaers³

et al. 2005

Journal of Clinical Investigation

425

245

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The vascular endothelium controls vasomotor tone and microvascular flow and regulates trafficking of nutrients and biologically active molecules. When endothelial activation is excessive, compromised microcirculation and subsequent cellular hypoxia contribute to the risk of organ failure. We hypothesized that strict blood glucose control with insulin during critical illness protects the endothelium, mediating prevention of organ failure and death. In this preplanned subanalysis of a large, randomized controlled study, intensive insulin therapy lowered circulating levels of ICAM-1 and tended to reduce E-selectin levels in patients with prolonged critical illness, which reflects reduced endothelial activation. This effect was not brought about by altered levels of endothelial stimuli, such as cytokines or VEGF, or by upregulation of eNOS. In contrast, prevention of hyperglycemia by intensive insulin therapy suppressed iNOS gene expression in postmortem liver and skeletal muscle, possibly in part via reduced NF-κB activation, and lowered the elevated circulating NO levels in both survivors and nonsurvivors. These effects on the endothelium statistically explained a significant part of the improved patient outcome with intensive insulin therapy. In conclusion, maintaining normoglycemia with intensive insulin therapy during critical illness protects the endothelium, likely in part via inhibition of excessive iNOS-induced NO release, and thereby contributes to prevention of organ failure and death.

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“…As previously demonstrated by others, the initial production of IL-10 in serum increases within the first 3 days after an injury [19,20,22]. Despite statistically significant correlations between IL-10 and GCS, the clinical relevance of this association may be not relevant (r 2 = –0.42) and may be influenced by some extreme values.…”

Section: Discussionmentioning

confidence: 63%

“…when necessary. Most of these variables, isolated or combined, were proven to be associated with TBI outcome in our patients and other populations [1,2,16,17,18,19,20]. The analyzed outcome was death during hospitalization.…”

Section: Methodsmentioning

confidence: 99%

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

Soares

Souza²,

Schwarzbold

et al. 2012

Neuroimmunomodulation

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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.

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Serum interleukin-10 in ICU patients with severe acute central nervous system injuries

Abstract: After acute brain injury, serum IL-10 in adults is detectable independent of CNS lesion type. Its systemic release is strongly individualized. Serum IL-10 on ICU admission may have some prognostic value to predict development of infection in patients with CNS lesions.

Cited by 23 publications

References 20 publications

Relationship of Serum and Cerebrospinal Fluid Biomarkers With Intracranial Hypertension and Cerebral Hypoperfusion After Severe Traumatic Brain Injury

Relationship of Serum and Cerebrospinal Fluid Biomarkers With Intracranial Hypertension and Cerebral Hypoperfusion After Severe Traumatic Brain Injury

Intensive insulin therapy protects the endothelium of critically ill patients

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

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