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Cytokine Levels (IL-4, IL-6, IL-8 and TGFβ) as Potential Biomarkers of Systemic Inflammatory Response in Trauma Patients

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Abstract

Purpose

Much research is now being conducted in order to understand the role of cytokines in the development of the inflammatory response following trauma. The purpose of this study was to evaluate whether serum levels of certain cytokines, measured immediately after initial injury, can be used as potential biomarkers for predicting the development and the degree of severity of the systemic inflammatory response (SIRS) in patients with moderate and severe trauma.

Methods

We conducted a prospective study with 71 individuals of whom 13 (18.3 %) were healthy controls and 58 (81.7 %) were traumatized orthopaedic patients who were categorized into two groups: 31 (43.6 %) with moderate injuries and 27 (38.1 %) patients with severe orthopaedic trauma. Thirty cc of heparinized blood were drawn from each individual within a few hours after the injury. Serum levels of pro-inflammatory, regulatory and anti-inflammatory cytokines were measured in each individual participant.

Results

High levels of pro-inflammatory cytokines IL-1β,-6,-8,-12, tumour necrosis factor alpha and interferon gamma were found in all injured patients compared to healthy controls. Only IL-6 and IL-8 were significantly higher in the injured patients. Levels of the regulatory cytokines, transformed growth factor beta (TGF-β) and IL-10 were higher in the injured patients, but significant only for TGF-β. Levels of IL-4 were significantly lower in the injured groups as compared to the controls.

Conclusions

Secretion of large amounts of pro-inflammatory cytokines and decreased level of anti-inflammatory cytokines during the acute phase of trauma may lead to the development of systemic inflammatory response syndrome (SIRS) in unstable polytraumatized patients. SIRS may result in life threatening conditions as acute respiratory distress syndrome (ARDS) and multiple organ failure (MOF). High levels of IL-6, IL-8, TGFβ and low levels of IL-4 were found to be reliable markers for the existence of immune reactivity in trauma patients. More research is needed to study pattern of cytokine levels along the acute period of injury, after surgical interventions and during recovery.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Western Galilee Hospital, Naharia, Israel

    Gershon Volpin & Michael Assaf

  2. The Galilee Medical Faculty Zfad, Bar Ilan University, Ramat Gan, Israel

    Gershon Volpin & Michael Assaf

  3. Department of Gerontology and School of Social Work, Faculty of Social Welfare and Health Sciences, University of Haifa, Mount Carmel, Haifa, Israel

    Miri Cohen

  4. R. & B. Rappaport Faculty of Medicine, Technion, Haifa, Israel

    Tamar Meir, Rina Katz & Shimon Pollack

  5. Institute of Clinical Immunology, Allergy & AIDS, Rambam Health Care Campus, Haifa, Israel

    Shimon Pollack

Authors
  1. Gershon Volpin
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  2. Miri Cohen
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  3. Michael Assaf
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  4. Tamar Meir
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  5. Rina Katz
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  6. Shimon Pollack
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Correspondence to Gershon Volpin.

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Volpin, G., Cohen, M., Assaf, M. et al. Cytokine Levels (IL-4, IL-6, IL-8 and TGFβ) as Potential Biomarkers of Systemic Inflammatory Response in Trauma Patients. International Orthopaedics (SICOT) 38, 1303–1309 (2014). https://doi.org/10.1007/s00264-013-2261-2

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  • DOI: https://doi.org/10.1007/s00264-013-2261-2

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