Serum interleukin-10 in ICU patients with severe acute central nervous system injuries
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- Dziurdzik, P., Krawczyk, L., Jalowiecki, P. et al. Inflamm. res. (2004) 53: 338. doi:10.1007/s00011-004-1265-1
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Rationale:IL-10, the main anti-inflammatory cytokine, may play a pivotal role in cerebral inflammation implicated in the development of brain edema and secondary brain damage after injury.
Aim of the study:1) Determining absolute IL-10 serum level and its pattern in critically ill patients with traumatic and non-traumatic acute brain injury. 2) Assessment of prognostic value of serum IL-10 in those patients.
Materials and methods:Serum IL-10 levels in 46 adults (multi-profile ICU, teaching hospital) with traumatic brain injury (TBI, N = 18), nontraumatic intracranial hemorrhage (SAH, N = 11) and polytrauma with concomitant brain injury (POL, N = 17) were measured using ELISA. Relationship of IL-10 and initial diagnosis, clinical state, outcome and risk of infection development was evaluated.
Results:IL-10 was detectable in the serum of all but one patient on ICU admission (56.6 ± 91.9 pg/ml; mean ± SD). No statistically significant differences in IL-10 between TBI, SAH and POL groups as well as between survivors and non-survivors on any day were found. No correlation between IL-10 and GCS or SAPS II was seen. Significant fall in serum IL-10 during the first 4 days of injury in patients of all subgroups was observed. Patients with initial serum IL-10 below 77pg/ml were at significantly higher risk of development of any infection within the first week of injury.
Conclusions:After acute brain injury, serum IL-10 in adults is detectable independent of CNS lesion type. Its systemic release is strongly individualized. Serum IL-10 on ICU admission may have some prognostic value to predict development of infection in patients with CNS lesions.