Serum interleukin-10 in ICU patients with severe acute central nervous system injuries.
BACKGROUND
IL-10, the main anti-inflammatory cytokine, may play a pivotal role in cerebral inflammation implicated in the development of brain edema and secondary brain damage after injury.


OBJECTIVE
1) Determining absolute IL-10 serum level and its pattern in critically ill patients with traumatic and non-traumatic acute brain injury. 2) Assessment of prognostic value of serum IL-10 in those patients.


METHODS
Serum IL-10 levels in 46 adults (multi-profile ICU, teaching hospital) with traumatic brain injury (TBI, N = 18), nontraumatic intracranial hemorrhage (SAH, N = 11) and polytrauma with concomitant brain injury (POL, N = 17) were measured using ELISA. Relationship of IL-10 and initial diagnosis, clinical state, outcome and risk of infection development was evaluated.


RESULTS
IL-10 was detectable in the serum of all but one patient on ICU admission (56.6 +/- 91.9 pg/ml; mean +/- SD). No statistically significant differences in IL-10 between TBI, SAH and POL groups as well as between survivors and non-survivors on any day were found. No correlation between IL-10 and GCS or SAPS II was seen. Significant fall in serum IL-10 during the first 4 days of injury in patients of all subgroups was observed. Patients with initial serum IL-10 below 77 pg/ml were at significantly higher risk of development of any infection within the first week of injury.


CONCLUSIONS
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.
Clinical Department of Anesthesiology and Intensive Care, Chair of Anesthesiology, Intensive Therapy and Emergency Medicine, Medical University of Silesia, Katowice, Poland. anestitsos@slam.katowice.pl
P
P
Dziurdzik
L
L
Krawczyk
P
P
Jalowiecki
Z
Z
Kondera-Anasz
L
L
Menon
D000328:Adult; D015415:Biomarkers; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D016753:Interleukin-10 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D015599:Trauma Severity Indices; D020196:Trauma, Nervous System / Q000097:blood* / Q000401:mortality
D015415:Biomarkers; D016753:Interleukin-10