Analysis of systemic interleukin-11 after major trauma

Recent data have shown that anti-inflammatory responses to major injury occur immediately after trauma. Interleukin 11 (IL-11), a member of the IL-6 family, is a pleiotropic cytokine with hematopoietic, osteotrophic, and mucosa protective properties, as well as anti-inflammatory functions. IL-11 inhibits synthesis of proinflammatory cytokines, promotes a Th2-type immune response, and improves outcome after shock and sepsis in different animal models. To further investigate the role of IL-11 in the human posttraumatic immune response, we measured plasma levels of IL-11 in 216 multiple-injured patients (mean age of 40 +/- 16 [range 11-81] years; Injury Severity Score [ISS] of 31 +/- 11 [range 16-66] points; 52 women and 164 men) after injury and correlated this with demographics, clinical course, and other laboratory parameters. IL-11 was significantly elevated in polytraumatized patients compared with healthy donors (P <0.0001). The time course of IL-11 in surviving patients was an initial increase after trauma with a decrease during the first 4 weeks, whereas nonsurvivors (n=34) had a significant increase later after injury (4 weeks). IL-11 was significantly higher after abdominal trauma and in men. No correlation between systemic IL-11 and ISS or age was detected. IL-11 correlated significantly with other pro- and anti-inflammatory cytokines such as IL-18. Our data demonstrate elevated levels of systemic IL-11 after multiple injuries; however, the role of a posttraumatic increase of IL-11 has to be further analyzed. In contrast to IL-6, IL-11 in plasma does not correlate with trauma severity and seems to have no clinical relevance to outcome prediction after trauma.