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Interleukin 1beta and interleukin 6 relationship with paediatric head trauma severity and outcome
Antonio Chiaretti1, Orazio Genovese, Luigi Aloe
1Paediatric Intensive Care Unit, Catholic University Medical School, Rome, Italy. achiaretti@yahoo.it <achiaretti@yahoo.it>
Insights
Increased levels of interleukin-1 beta (IL-1beta) and interleukin-6 (IL-6) in cerebrospinal fluid and plasma correlate with traumatic brain injury (TBI) severity and poor outcomes in children. This suggests a significant neuroinflammatory response following pediatric TBI.
Area of Science:
- Neuroscience
- Immunology
- Pediatric Critical Care
Background:
- Interleukins (IL) are known to play a role in inflammation.
- Traumatic brain injury (TBI) can trigger inflammatory responses.
- Understanding these responses is crucial for predicting outcomes in pediatric TBI.
Purpose of the Study:
- To evaluate the expression of IL-1beta and IL-6 in children with severe TBI.
- To assess the association between IL-1beta and IL-6 levels and TBI severity (Glasgow Coma Scale [GCS]).
- To determine the relationship between interleukin levels and clinical outcome (Glasgow Outcome Score [GOS]).
Main Methods:
- A prospective observational clinical study was conducted in a pediatric intensive care unit.
- IL-1beta and IL-6 levels were measured in cerebrospinal fluid (CSF) and plasma of 14 children with severe TBI and 12 controls.
- Samples were collected at 2 hours (T1) and 24 hours (T2) post-TBI using an immunoenzymatic method.
Main Results:
- IL-6 levels were significantly higher than IL-1beta levels in both CSF and plasma of TBI patients.
- Both IL-1beta and IL-6 levels increased from T1 to T2 in CSF and plasma.
- Increased interleukin levels correlated significantly with TBI severity (GCS ≤ 5) and poor outcome (GOS ≤ 3).
Conclusions:
- Elevated IL-1beta and IL-6 expression after TBI indicates an endogenous neuroinflammatory response.
- These interleukin increases are linked to head injury severity in children.
- The findings suggest that IL-1beta and IL-6 levels can predict poor clinical outcomes in pediatric TBI.
Background:
Based on the known inflammatory role of interleukins (IL), we evaluated IL-1beta and IL-6 expressions and their association with the severity of traumatic brain injury (TBI; Glasgow Coma Scale [GCS]) and the outcome (Glasgow Outcome Score [GOS]) recorded in a paediatric population.
Design:
The design was a perspective observational clinical study carried out in the paediatric intensive care unit of the University Hospital.
Methods:
We measured the IL-1beta and IL-6 levels in 14 children with severe TBI (patients) and in 12 children with obstructive hydrocephalus (control group). Cerebrospinal fluid (CSF) and plasma samples were collected 2 h (T1) and 24 h (T2) after TBI. Interleukins were assayed using the immunoenzymatic method.
Results:
The IL-1beta mean level was significantly lower than the IL-6 mean level both in the CSF and plasma of TBI children. In the CSF, the IL-1beta level increased from 55.71+/-72.79 pg/ml at T1 to 106.10+/-142.12 pg/ml at T2 and the IL-6 level increased from 405.43+/-280.28 pg/ml at T1 to 631.57+/-385.35 pg/ml at T2; a similar trend was observed in plasma. We found a statistically significant correlation between the increase in CSF and plasma interleukin levels between T1 and T2 and head injury severity (GCS
Conclusions:
The increases in IL-1beta and IL-6 expression were correlated with head injury severity and were indicative of poor clinical outcome, reflecting an endogenous neuroinflammatory response after TBI.
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