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.
Dziurdzik
P
P
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
Krawczyk
L
L
Jalowiecki
P
P
Kondera-Anasz
Z
Z
Menon
L
L
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