title: Transcranial cytokine gradients in patients requiring intensive care after acute brain injury.
abstract: After acute brain injury there may be increased intracranial production of cytokines, with activation of inflammatory cascades. We have sought to determine if a transcranial cytokine gradient was demonstrable in paired sera of 32 patients requiring intensive care after acute brain injury. The difference between concentrations of IL-1 beta, IL-6, IL-8 and TNF alpha in jugular venous and arterial serum was measured on admission, and at 24, 48 and 96 h after the primary injury. There were no differences in IL-1 beta, IL-8 or TNF alpha, but median gradients of 6.7 and 11.5 pg ml-1 for IL-6 were demonstrated in the traumatic brain injury (n = 22) and subarachnoid haemorrhage (n = 10) groups, respectively (normal values in serum < 4.7 pg ml-1; P < 0.001 both groups). This suggests that there is significant production of IL-6 by intracranial cells after acute brain injury. Therapy directed towards combatting the negative effects of IL-6 may potentially benefit patients who have sustained an acute brain injury.
authors.affiliation: Department of Clinical Neurosciences, University of Edinburgh, Western General Hospital.
authors.forename: E G
authors.initials: EG
authors.lastname: McKeating
authors.forename: P J
authors.initials: PJ
authors.lastname: Andrews
authors.forename: D F
authors.initials: DF
authors.lastname: Signorini
authors.forename: L
authors.initials: L
authors.lastname: Mascia
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D001921:Brain / Q000378:metabolism*; D001930:Brain Injuries / Q000378:metabolism*; D003422:Critical Care; D016207:Cytokines / Q000097:blood*; D005260:Female; D006801:Humans; D007375:Interleukin-1 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D007601:Jugular Veins; D008297:Male; D008875:Middle Aged; D013345:Subarachnoid Hemorrhage / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
chemical_list: D016207:Cytokines; D007375:Interleukin-1; D015850:Interleukin-6; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha