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- Title
Plasma profiles of inflammatory cytokines in children with moderate to severe traumatic brain injury: a prospective cohort study.
- Authors
Huang, Haixin; Fu, Guo; Lu, Siwei; Chen, Song; Huo, Junming; Ran, Yunni; Xiao, Changxue; Chen, Jian; Pi, Dandan; Zhou, Fang; Dang, Hongxing; Liu, Chengjun; Fu, Yue-qiang
- Abstract
The role of inflammatory cytokines in children with moderate to severe TBI (m-sTBI) is still incompletely understood. We aimed to investigate the associations between early plasma expression profiles of inflammatory cytokines and clinical outcomes in children with m-sTBI. We prospectively recruited children admitted to the intensive care unit (ICU) of a tertiary pediatric hospital due to m-sTBI from November 2022 to May 2023. Plasma interleukin (IL)-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-17A, interferon (IFN)-α, IFN-γ and tumor necrosis factor (TNF)-α concentrations were detected by flow cytometry on admission and on days 5 to 7. The primary outcome was in-hospital mortality. The secondary outcome was the 6-month functional outcome assessed by the Glasgow Outcome Scale Extended-Pediatrics (GOS-E Peds) score, dichotomized as favorable (1–4) or unfavorable (5–8). Fifty patients and 20 healthy controls were enrolled. Baseline IL-6, IL-8 and IL-10 levels were significantly higher in TBI patients than in healthy controls. Twelve patients died in the hospital. Compared with survivors, nonsurvivors had significantly increased baseline IL-6 and IL-8 levels. Baseline IL-5, IL-6 and IL-8 levels were also significantly greater in children with unfavorable versus favorable outcomes. The area under the receiver operating characteristic curve (AUC) of the IL-6 and IL-8 levels and motor Glasgow Coma Scale (GCS) score for predicting in-hospital mortality was 0.706, 0.754, and 0.776, respectively. Baseline IL‐1β, IL‐2, IL‐4, IL‐10, IL‐12p70, IL‐17A, IFN‐γ, IFN-α and TNF-α levels were not associated with in-hospital mortality or an unfavorable 6-month outcome. On days 5 to 7, the IL-6 and IL-8 levels were significantly decreased in survivors but increased in nonsurvivors compared to their respective baselines. Conclusion: After m-sTBI, the plasma profiles of inflammatory cytokines are markedly altered in children. The trends of IL-6 and IL-8 expression vary among m-sTBI children with different outcomes. Elevated plasma IL-6 and IL-8 levels are related to in-hospital mortality and unfavorable 6-month outcomes. Trial registration: This trial was registered in the Chinese Clinical Trial Registry (Registration number: ChiCTR2200065505). Registered November 7, 2022. What is Known: • Inflammation is an important secondary physiological response to TBI. What is New: • The plasma profiles of inflammatory cytokines are markedly altered in children with m-sTBI. Elevated IL-6 and IL-8 levels are related to mortality and unfavorable outcomes.
- Subjects
BRAIN injuries; TUMOR necrosis factors; RECEIVER operating characteristic curves; CYTOKINES; COHORT analysis
- Publication
European Journal of Pediatrics, 2024, Vol 183, Issue 8, p3359
- ISSN
0340-6199
- Publication type
Article
- DOI
10.1007/s00431-024-05604-5