Cerebrospinal IL-10 concentration is elevated in non-survivors as compared to survivors after severe traumatic brain injury.
OBJECTIVE
The intrathecal posttraumatic inflammation contributes to secondary brain damage as well as to the induction of neuroreparative mechanisms. In this context release of interleukin-10 (IL-10) has been reported to play a major role. However, initial IL-10 concentration in CSF remains incompletely characterized. Therefore, the aim was to analyze Il-10 in CSF and serum of patients early after TBI.


METHODS
For control, 10 volunteers receiving spinal puncture were enrolled. In patients with severe TBI (GCS<8 pts.), CSF and serum was drawn within 90+/-45 min after intraventricular catheter insertion (0 h), as well as 12 h, 24 h and 48 h after TBI. Albumin for assessing Blood-Brain-Barrier (BBB) function and IL-10 (IMMULITE, DPC Biermann, Bad Nauheim, Germany) were analyzed.


RESULTS
23 patients were enrolled. 15 survived and 8 deceased within 24h. In controls, CSF IL-10 was below detection limit (<5 pg/ml). In contrast, IL-10 was elevated significantly in non-survivors at 0 h vs. survivors and controls (30+/-6 vs. 9+/-1 vs. <5 pg/mL). This was accompanied by a significant increase of serum IL-10 in both groups at 0 h vs. controls (survivors: 30+/-6 pg/mL, non-survivors: 48+/-8 pg/mL, controls: 10+/-7 pg/mL, p<0.001). Survivors revealed signs of a mild BBB dysfunction during the entire observation period. In contrast, non-survivors presented a severe BBB breakage.


CONCLUSIONS
We demonstrated an analysis of IL-10 CSF and serum concentration after TBI. These data support an intrathecal IL-10 synthesis. Although the significant increase of IL-10 might indicate a bad outcome of TBI, responsible mechanisms still have to be elucidated.
Kirchhoff
C
C
Abteilung für Sportorthopädie, Klinikum Rechts der Isar, Technische Universität München, Conollystrasse 32, 80809 München, Germany. Chlodwig.Kirchhoff@med.uni-muenchen.de
Buhmann
S
S
Bogner
V
V
Stegmaier
J
J
Leidel
B A
BA
Braunstein
V
V
Mutschler
W
W
Biberthaler
P
P
D000328:Adult; D001812:Blood-Brain Barrier; D001930:Brain Injuries / Q000097:blood / Q000134:cerebrospinal fluid* / Q000503:physiopathology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood / Q000134:cerebrospinal fluid; D016753:Interleukin-10 / Q000097:blood / Q000134:cerebrospinal fluid*; D008297:Male; D008875:Middle Aged; D011379:Prognosis
C508609:IL10 protein, human; D018836:Inflammation Mediators; D016753:Interleukin-10