Serum IL-6: A candidate biomarker for intracranial pressure elevation following isolated traumatic brain injury
Increased intracranial pressure (ICP) is a serious, life-threatening, secondary event following traumatic brain injury (TBI). In many cases, ICP rises in a delayed fashion, reaching a maximal level 48-96 hours after the initial insult.
While pressure catheters can be implanted to monitor ICP, there is no clinically proven method for determining a patient's risk for developing this pathology.
Methods: In the present study, we employed antibody array and Luminex-based screening methods to interrogate the levels of inflammatory cytokines in the serum of healthy volunteers and in severe TBI patients (GCS less than or equal to 8) with or without incidence of elevated intracranial pressure (ICP). De-identified samples and ELISAs were used to confirm the sensitivity and specificity of IL-6 as a prognostic marker of elevated ICP in both isolated TBI patients, and polytrauma patients with TBI.
Results: Consistent with previous reports, we observed sustained increases in IL-6 levels in TBI patients irrespective of their ICP status.
However, the group of patients who subsequently experienced ICP greater than or equal to 25mm Hg had significantly higher IL-6 levels within the first 17 hours of injury as compared to the patients whose ICP remained less than or equal to 20mm Hg. When blinded samples (n=22) were assessed, a serum IL-6 cut-off of <5pg/ml correctly identified 100% of all the healthy volunteers, a cut-off of >128pg/ml correctly identified 85% of isolated TBI patients who subsequently developed elevated ICP, and values between these cut-off values correctly identified 75% of all patients whose ICP remained less than or equal to 20mm Hg throughout the study period.
In contrast, the marker had no prognostic value in predicting elevated ICP in polytrauma patients with TBI. When the levels of serum IL-6 were assessed in patients with orthopedic injury (n=7) in the absence of TBI, a significant increase was found in these patients compared to healthy volunteers, albeit lower than that observed in TBI patients.
Conclusions: Our results suggest that serum IL-6 can be used for the differential diagnosis of elevated ICP in isolated TBI.
Author: Georgene HergenroederAnthony MooreJ. Phillip McCoyLeigh SamselNorman WardGuy CliftonPramod Dash
Credits/Source: Journal of Neuroinflammation 2010, 7:19
Published on: 2010-03-11
Copyright by the authors listed above - made available via BioMedCentral (Open Access). Please
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