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Updated: Jan 1, 2026
Systems Analysis of the Neuroinflammatory and Hemodynamic Response to Traumatic Brain Injury
Published on: May 27, 2022
Interleukin-8 Predicts Fatigue at 12 Months Post-Injury in Children with Traumatic Brain Injury
Alison Crichton1,2, Vera Ignjatovic1,3, Franz E Babl1,3,4
1Murdoch Children's Research Institute, Melbourne, Australia.
Insights
Serum interleukin-8 (IL-8) levels measured soon after traumatic brain injury (TBI) in children can predict persistent fatigue. This biomarker improves predictions beyond standard injury severity measures.
Area of Science:
- Pediatric Neurology
- Neurotrauma Biomarkers
- Childhood Brain Injury Research
Background:
- Fatigue is a common yet poorly understood consequence of childhood traumatic brain injury (TBI).
- Traditional measures of TBI severity do not reliably predict long-term fatigue in children.
- Identifying early predictors is crucial for understanding and managing post-TBI fatigue.
Purpose of the Study:
- To determine if serum biomarker concentrations predict persistent fatigue in children after TBI.
- To investigate if acute serum biomarker levels improve prediction models of 12-month fatigue based on injury severity.
Main Methods:
- Blood samples were collected within 24 hours of injury from 87 children (1-17 years) with mild to severe TBI.
- Measured serum biomarkers included IL-6, IL-8, SVCAM, S100B, NSE, and sNCAM.
- Fatigue at 12 months post-injury was assessed using the Pediatric Quality of Life Inventory Multidimensional Fatigue Scale.
Main Results:
- Twenty-two percent of children experienced fatigue 12 months after TBI.
- Interleukin-8 (IL-8) concentration was the strongest serum biomarker for predicting 12-month fatigue.
- Including IL-8 in the model significantly enhanced the prediction of fatigue based on injury severity.
Conclusions:
- Acute serum IL-8 levels are a significant predictor of persistent fatigue in children following TBI.
- IL-8 measurement offers a valuable addition to existing methods for predicting post-TBI fatigue.
- Further research into IL-8's role may lead to targeted interventions for fatigue management in pediatric TBI survivors.
Abstract:
Despite many children experiencing fatigue after childhood brain injury, little is known about the predictors of this complaint. To date, traditional indices of traumatic brain injury (TBI) severity have not predicted reliably persisting fatigue (up to three years post-injury). This study aimed to establish whether persisting fatigue is predicted by serum biomarker concentrations in child TBI. We examined whether acute serum biomarker expression would improve prediction models of 12-month fatigue based on injury severity. Blood samples were collected from 87 children (1-17 years at injury) sustaining mild to severe TBI (Glasgow Coma Scale [GCS] range 3-15; mean 12.43; classified as mild TBI [n = 50, 57%] vs. moderate/severe TBI [n = 37, 43%]), and presenting to the emergency departments (ED) and pediatric intensive care units (PICU) at one of three tertiary pediatric hospitals (Royal Children's Hospital (RCH); Hospital for Sick Children (HSC), Toronto; St Justine Children's Hospital (SJH), Montreal). Six serum biomarker concentrations were measured within 24 h of injury (interleukin-6, interleukin-8 [IL-8], soluble vascular cell adhesion molecule [SVCAM], S100 calcium binding protein B [S100B], neuron specific enolase [NSE], and soluble neural cell adhesion molecule [sNCAM]). Fatigue at 12 months post-injury was measured using the Pediatric Quality of Life Inventory Multidimensional Fatigue Scale (parent report), classified as present/absent using previously derived cut-points. At 12 months post-injury, 22% of participants experienced fatigue. A model including IL-8 was the best serum biomarker for estimating the probability of children experiencing fatigue at 12 months post-injury. The IL-8 also significantly improved predictive models of fatigue based on severity.
