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.
Sutherland
A G
AG
Department of Orthopaedics, University of Aberdeen Medical School, Polwarth Building, Foresterhill, AB9 2ZD, Scotland, Aberdeen, UK. ort025@abdn.ac.uk
Alexander
D A
DA
Hutchison
J D
JD
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