title: Cerebrospinal fluid and plasma cytokines after subarachnoid haemorrhage: CSF interleukin-6 may be an early marker of infection.
abstract: BACKGROUND
  Cytokines and cytokine receptor concentrations increase in plasma and cerebrospinal fluid (CSF) of patients following subarachnoid haemorrhage (SAH). The relationship between plasma and CSF cytokines,  and factors affecting this, are not clear.
  
  
  METHODS
  To help define the relationship, paired plasma and cerebrospinal fluid (CSF) samples were collected from patients subject to ventriculostomy. Concentrations of key inflammatory cytokines, interleukin (IL)-1ß, IL-1 receptor antagonist (IL-1Ra), IL-1 receptor 2, IL-6, IL-8, IL-10, tumour necrosis factor (TNF)-α, and TNF receptors (TNF-R) 1 and 2 were determined by immunoassay of CSF and plasma from 21 patients, where samples were available at three or more time points.
  
  
  RESULTS
  Plasma concentrations of IL-1ß, IL-1Ra, IL-10, TNF-α and TNF-R1 were similar to those in CSF. Plasma TNF-R2 and IL-1R2 concentrations were higher than in CSF. Concentrations of IL-8 and IL-6 in CSF were approximately10 to 1,000-fold higher than in plasma. There was a weak correlation between CSF and plasma IL-8 concentrations (r = 0.26), but no correlation for IL-6. Differences between the central and peripheral pattern of IL-6 were associated with episodes of ventriculostomy-related infection (VRI). A VRI was associated with CSF IL-6 >10,000 pg/mL (P = 0.0002), although peripheral infection was not significantly associated with plasma IL-6.
  
  
  CONCLUSIONS
  These data suggest that plasma cytokine concentrations cannot be used to identify relative changes in the CSF, but that measurement of CSF IL-6 could provide a useful marker of VRI.
authors.affiliation: The University of Manchester Stroke & Vascular Centre, Manchester Academic Health Science Centre, Salford Royal Hospitals Foundation Trust, Eccles Old Road, Stott Lane, Salford, M6 8HD, UK. Steve.Hopkins@manchester.ac.uk
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Hopkins
authors.forename: Catherine J
authors.initials: CJ
authors.lastname: McMahon
authors.forename: Navneet
authors.initials: N
authors.lastname: Singh
authors.forename: James
authors.initials: J
authors.lastname: Galea
authors.forename: Margaret
authors.initials: M
authors.lastname: Hoadley
authors.forename: Sylvia
authors.initials: S
authors.lastname: Scarth
authors.forename: Hiren
authors.initials: H
authors.lastname: Patel
authors.forename: Andy
authors.initials: A
authors.lastname: Vail
authors.forename: Sharon
authors.initials: S
authors.lastname: Hulme
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Rothwell
authors.forename: Andrew T
authors.initials: AT
authors.lastname: King
authors.forename: Pippa J
authors.initials: PJ
authors.lastname: Tyrrell
mesh_terms: D000328:Adult; D000368:Aged; D016207:Cytokines / Q000097:blood* / Q000134:cerebrospinal fluid*; D005260:Female; D006801:Humans; D007239:Infections / Q000097:blood / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D018121:Receptors, Cytokine / Q000378:metabolism*; D013345:Subarachnoid Hemorrhage / Q000097:blood* / Q000134:cerebrospinal fluid*; D014696:Ventriculostomy / Q000009:adverse effects / Q000379:methods
chemical_list: D016207:Cytokines; D018121:Receptors, Cytokine