Interleukin-10 is an independent biomarker of severe traumatic brain injury prognosis.
BACKGROUND
Cytokines have been shown to be involved in traumatic brain injury (TBI). We investigated the independent association between serum levels of IL-10 and TNF-α and hospital mortality of patients with severe TBI.


METHODS
Serum IL-10 and TNF-α levels were determined after a median period (interquartile range (IQ) 25-75) of 10 h (IQ 5-18) after severe TBI in 93 consecutive patients and in randomly selected patients with mild (n = 18) and moderate (n = 16) TBI. In patients with severe TBI, additional blood samples were analyzed 30 h (IQ 22-37) and 68 h (IQ 55-78) after TBI. Age, gender, computed tomography findings, Glasgow Coma Scale score (GCS) and pupil reactions at admission, associated trauma and hospital mortality were collected.


RESULTS
Elevated serum levels of IL-10, but not TNF-α, correlated significantly with GCS severity (R(2) coefficient, p < 0.0001) and were found to be associated with hospital mortality in patients with severe TBI. Elevated IL-10 remained associated with mortality (p = 0.01) in a subset of patients with isolated severe TBI (n = 74). Multiple logistic regression analysis showed that higher IL-10 levels (>90 pg/ml) at 10 or 30 h after TBI were 6 times (odds ratio (OR) 6.2, 95% confidence interval (CI) 1.2-25.1, p = 0.03) and 5 times (OR 5.4, 95% CI 1.2-25.1, p = 0.03), respectively, more frequently associated with hospital mortality than lower levels (<50 pg/ml), independently of age, GCS as well as pupil reactions at admission and associated trauma.


CONCLUSIONS
Serum IL-10 levels may be a useful marker for severe TBI prognosis.
Centro de Neurociências Aplicadas, Hospital Universitário, Universidade Federal de Santa Catarina,  Florianópolis, Brasil.
Flávia Mahatma
FM
Schneider Soares
Nicole
N
Menezes de Souza
Marcelo
M
Libório Schwarzbold
Alexandre
A
Paim Diaz
Jean
J
Costa Nunes
Alexandre
A
Hohl
Priscilla
P
Nunes Abreu da Silva
Juliana
J
Vieira
Rafael
R
Lisboa de Souza
Melina
M
Moré Bertotti
Rui Daniel
RD
Schoder Prediger
Marcelo
M
Neves Linhares
André
A
Bafica
Roger
R
Walz
D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001930:Brain Injuries / Q000097:blood / Q000175:diagnosis* / Q000276:immunology*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D016753:Interleukin-10 / Q000096:biosynthesis* / Q000097:blood; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D015854:Up-Regulation / Q000276:immunology*; D055815:Young Adult
D015415:Biomarkers; C508609:IL10 protein, human; D016753:Interleukin-10