title: Local and systemic pro-inflammatory and anti-inflammatory cytokine patterns in patients with chronic subdural hematoma: a prospective study.
abstract: OBJECTIVE
  Innate immune pro- and anti-inflammatory responses in patients with chronic subdural hematoma (CSDH) were investigated by measuring and comparing the systemic and subdural fluid levels of cytokines.
  
  
  METHODS
  Cytokine values were analyzed in samples obtained during surgery of 56 adult patients who were operated on for unilateral CSDHs using a Multiplex antibody bead kit.
  
  
  RESULTS
  There were significantly higher levels of the pro-inflammatory IL-2R (p = 0.004), IL-5 (p < 0.001), IL-6 (p < 0.001), and IL-7 (p < 0.001), and anti-inflammatory mediators IL-10 (p < 0.001) and IL-13 (p = 0.002) in CSDH fluid compared with systemic levels. The pro-inflammatory TNF-alpha (p < 0.001), IL-1beta (p < 0.001), IL-2 (p = 0.007) and IL-4 (p < 0.001) were significantly lower in hematoma fluid compared with systemic levels. The ratios between pro- versus anti-inflammatory cytokines were statistically significant higher in CSDH (7.8) compared with systemic levels (1.3).
  
  
  CONCLUSIONS
  The innate immune responses occur both locally at the site of CSDH, as well as systematically in patients with CSDH. The local hyper-inflammatory and low anti-inflammatory responses exist simultaneously. The findings suggest poorly coordinated innate immune responses at the site of CSDH that may lead to propagating of local inflammatory process and basically contribute to formation and progression of CSDH.
authors.affiliation: Department of Neurosurgery, Oslo University Hospital, Oslo, Norway. mstanisi@ous-hf.no
authors.forename: Milo
authors.initials: M
authors.lastname: Stanisic
authors.forename: Ansgar Oddne
authors.initials: AO
authors.lastname: Aasen
authors.forename: Are Hugo
authors.initials: AH
authors.lastname: Pripp
authors.forename: Karl-Fredrik
authors.initials: KF
authors.lastname: Lindegaard
authors.forename: Jon
authors.initials: J
authors.lastname: Ramm-Pettersen
authors.forename: Staale Petter
authors.initials: SP
authors.lastname: Lyngstadaas
authors.forename: Jugoslav
authors.initials: J
authors.lastname: Ivanovic
authors.forename: Ane
authors.initials: A
authors.lastname: Konglund
authors.forename: Eivind
authors.initials: E
authors.lastname: Ilstad
authors.forename: Tiril
authors.initials: T
authors.lastname: Sandell
authors.forename: Omar
authors.initials: O
authors.lastname: Ellingsen
authors.forename: Terje
authors.initials: T
authors.lastname: Sæhle
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016207:Cytokines / Q000097:blood / Q000276:immunology*; D005260:Female; D020200:Hematoma, Subdural, Chronic / Q000097:blood / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D016207:Cytokines