Disturbance of pro-inflammatory cytokines in post-traumatic psychopathology.
BACKGROUND
Post-traumatic psychopathology (PTP) is important to the orthopaedic surgeon as it may complicate the recovery from musculoskeletal injury. PTP is associated with a disturbance of the hypothalamic-pituitary-adrenal axis, and may lead to impaired healing. We have investigated the relationship between PTP and pro-inflammatory markers of the metabolic response to trauma.


METHODS
A prospective cohort study of 82 patients with musculoskeletal injuries, correlating development of psychopathology (measured by general health questionnaire) and pro-inflammatory markers (CRP, IL-6, sIL-6r, TNF-alpha) two and six months after their injury.


RESULTS
Psychological disturbance was found in 39% of patients at two months and 18% at six months. This disturbance was associated with significantly increased levels of IL-6 at two months and of sIL-6r and TNF-alpha at six months. CRP levels were not related to the development of PTP.


CONCLUSIONS
The relationship between PTP and disturbances of pro-inflammatory markers needs further exploration, but may explain in part the impaired functional recovery when musculoskeletal trauma is complicated by psychological disturbance.
Department of Orthopaedics, University of Aberdeen Medical School, Polwarth Building, Foresterhill, AB9 2ZD, Scotland, Aberdeen, UK. ort025@abdn.ac.uk
A G
AG
Sutherland
D A
DA
Alexander
J D
JD
Hutchison
D000063:Accidents, Traffic / Q000523:psychology; D000328:Adult; D002097:C-Reactive Protein / Q000378:metabolism; D016207:Cytokines / Q000378:metabolism*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000378:metabolism*; D015850:Interleukin-6 / Q000378:metabolism; D008297:Male; D011599:Psychopathology; D019947:Receptors, Interleukin-6 / Q000378:metabolism; D013313:Stress Disorders, Post-Traumatic / Q000378:metabolism*; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D014945:Wound Healing / Q000502:physiology*
D016207:Cytokines; D015850:Interleukin-6; D019947:Receptors, Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein