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Published on: March 26, 2019
Interleukin-8 released into the cerebrospinal fluid after brain injury is associated with blood-brain barrier
T Kossmann1, P F Stahel, P M Lenzlinger
1Division of Trauma Surgery, University of Zürich Medical School, Switzerland.
Insights
Interleukin-8 (IL-8) is elevated in cerebrospinal fluid after severe traumatic brain injury, suggesting it drives nerve growth factor (NGF) production and contributes to brain injury pathology.
Area of Science:
- Neuroscience
- Immunology
- Biochemistry
Background:
- Severe traumatic brain injury (TBI) can lead to complex inflammatory responses within the central nervous system.
- The role of specific cytokines, such as Interleukin-8 (IL-8), in TBI pathogenesis requires further elucidation.
- Understanding the interplay between inflammatory mediators and neurotrophic factors is crucial for developing targeted therapies.
Purpose of the Study:
- To investigate the levels and potential role of Interleukin-8 (IL-8) in the cerebrospinal fluid (CSF) of patients with severe traumatic brain injury (TBI).
- To explore the relationship between IL-8, blood-brain barrier (BBB) integrity, and the presence of Nerve Growth Factor (NGF) in TBI patients.
- To determine if IL-8 directly influences NGF production in astrocytes and assess the efficacy of anti-IL-8 antibodies in mitigating this effect.
Main Methods:
- Measurement of IL-8 levels in CSF and serum from 14 severe TBI patients.
- Assessment of blood-brain barrier (BBB) dysfunction based on IL-8 CSF levels.
- Detection of Nerve Growth Factor (NGF) in CSF and correlation with IL-8 concentrations.
- In vitro experiments using cultured astrocytes exposed to CSF with varying IL-8 levels to measure NGF production.
- Application of anti-IL-8 antibodies to assess their impact on NGF release.
Main Results:
- IL-8 levels were significantly higher in CSF compared to serum in TBI patients, indicating intrathecal production.
- Elevated CSF IL-8 levels correlated with severe blood-brain barrier dysfunction.
- Patients with detectable NGF in CSF had significantly higher IL-8 concentrations.
- CSF containing high IL-8 concentrations stimulated greater NGF production in cultured astrocytes compared to low IL-8 samples.
- Anti-IL-8 antibodies partially inhibited NGF release, with complete inhibition not achieved, suggesting the involvement of other cytokines like TNF-alpha and IL-6.
Conclusions:
- IL-8 is a key inflammatory mediator in the CSF following severe TBI, likely produced intrathecally.
- IL-8 plays a significant role in inducing NGF production in astrocytes, potentially exacerbating TBI pathology.
- The findings suggest IL-8 is a pivotal cytokine in brain injury and a potential therapeutic target, possibly in combination with other anti-inflammatory agents.
Abstract:
Interleukin (IL) 8 was measured in CSF of 14 patients with severe traumatic brain injury. IL-8 levels were significantly higher in CSF (up to 8,000 pg/ml) than serum (up to 2,400 pg/ml) (p < 0.05), suggesting intrathecal production. Maximal IL-8 values in CSF correlated with a severe dysfunction of the blood-brain barrier. Nerve growth factor (NGF) was detected in CSF of 7 of 14 patients (range of maximal NGF: 62-12,130 pg/ml). IL-8 concentrations were significantly higher in these patients than in those without NGF (p < 0.01). CSF containing high IL-8 (3,800-7,900 pg/ml) induced greater NGF production in cultured astrocytes (202-434 pg/ml) than samples with low IL-8 (600-1,000 pg/ml), which showed a smaller NGF increase (0-165 pg/ml). Anti-IL-8 antibodies strongly reduced (52-100%) the release of NGF in the group of high IL-8, whereas in the group with low IL-8, this effect was lower (0-52%). The inability of anti-IL-8 antibodies to inhibit the synthesis of NGF completely may depend on cytokines like tumor necrosis factor alpha and IL-6 found in these CSF samples, which may act in association with IL-8. Thus, IL-8 may represent a pivotal cytokine in the pathology of brain injury.
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