title: Cytokine levels as potential biomarkers for predicting the development of posttraumatic stress symptoms in casualties of accidents.
abstract: BACKGROUND
  Traumatic injuries are usually associated with increased secretion of pro-inflammatory cytokines, and are sometimes followed by the development of acute stress symptoms (ASS) and posttraumatic stress symptoms (PTSS).
  
  
  OBJECTIVE
  To measure serum pro- and anti-inflammatory cytokines in accident casualties and to associate it with ASS at hospitalization, and with PTSS 1 month later.
  
  
  METHODS
  Participants were 48 patients, aged 20-60, hospitalized following various orthopedic injuries including bone fractures, and 13 healthy volunteers matched for gender. At hospitalization (Time 1), 30 ml heparinized venous blood were drawn and cytokines levels in serum were assessed; participants filled out the Acute Stress Disorder Inventory (ASDI), COPE, and injury-related questionnaires. One month later (Time 2), 26 participants filled out the Posttraumatic Disorder Symptom Scale (PDS).
  
  
  RESULTS
  High serum levels of IL-6, IL-8, and TGF-beta and low levels of serum IL-4 and IL-10 were found in injured patients as compared with controls, When controlling for age and severity of injury in the regression analysis, higher levels of IL-6 and IL-8 and lower TGF-beta were predicted by higher ASS and higher use of and emotion-focused coping. Higher PTSS scores at Time 2 were predicted by higher levels of IL-8, lower levels of TGF-beta, and higher ASS measured at Time 1.
  
  
  CONCLUSIONS
  High levels of the pro-inflammatory cytokine IL-6 and IL-8 and lower levels of the regulatory cytokine TGF-beta should be further assessed as a possible risk factor or a bio-marker of PTSS in accident casualties.
authors.affiliation: Western Galilee Hospital, Israel. cohenm@research.haifa.ac.il
authors.forename: Miri
authors.initials: M
authors.lastname: Cohen
authors.forename: Tamar
authors.initials: T
authors.lastname: Meir
authors.forename: Ehud
authors.initials: E
authors.lastname: Klein
authors.forename: Gershon
authors.initials: G
authors.lastname: Volpin
authors.forename: Michael
authors.initials: M
authors.lastname: Assaf
authors.forename: Shimon
authors.initials: S
authors.lastname: Pollack
mesh_terms: D000063:Accidents, Traffic / Q000523:psychology*; D000223:Adaptation, Psychological; D000328:Adult; D015415:Biomarkers / Q000097:blood*; D016207:Cytokines / Q000097:blood*; D004644:Emotions / Q000502:physiology; D005260:Female; D050723:Fractures, Bone / Q000276:immunology / Q000523:psychology; D006801:Humans; D007378:Interleukins / Q000097:blood; D008297:Male; D008875:Middle Aged; D017695:Soft Tissue Injuries / Q000276:immunology / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000276:immunology*; D040701:Stress Disorders, Traumatic, Acute / Q000175:diagnosis / Q000276:immunology*; D016212:Transforming Growth Factor beta / Q000097:blood; D014947:Wounds and Injuries / Q000276:immunology* / Q000523:psychology*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D016207:Cytokines; D007378:Interleukins; D016212:Transforming Growth Factor beta