Differences in Cerebral Extracellular Response of Interleukin-1β, Interleukin-6, and Interleukin-10 After Subarachnoid Hemorrhage or Severe Head Trauma in Humans
Differences in Cerebral Extracellular Response of Interleukin-1β, Interleukin-6, and Interleukin-10 After Subarachnoid Hemorrhage or Severe Head Trauma in Humans
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DOI：
10.1227/neu.0b013e3181ef2a40
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发表时间：
2011-01-01
期刊：
影响因子：
4.8
通讯作者：
Hillman, Jan
中科院分区：
文献类型：
--
作者：
Mellergard, Pekka;Aneman, Oscar;Hillman, Jan
背景：微透析法已成为神经外科重症监护病房患者生化监测的常规手段。目的：分析重型蛛网膜下腔出血或颅脑损伤后7天内脑组织细胞外3种白介素3(IL)水平的变化。方法：收集145例重型颅脑外科重症监护病房患者(蛛网膜下腔出血88例，颅脑损伤57例)的微透析液，每隔6小时收集一次，共7天。用荧光复合微球技术测定IL-1β和IL-6浓度，用酶联免疫吸附试验测定IL-10浓度。结果：给出了2种不同类型颅脑损伤后第1周内3种ILS的反应模式。这些模式对于每种IL是不同的，并且在病理影响的种类方面也是不同的。对于IL-1β和IL-6，最初的峰值(所有患者第2天的平均值分别为26.9+/-4.5和4399+/-848 pg/mL)随后逐渐下降，IL-6的值仍然是IL-1β的100倍。女性患者表现出更强烈和更持久的反应。IL-10的反应有所不同，平均值小于23pg/m L，且各天数之间无显著差异。3种ILS在蛛网膜下腔出血患者中的反应均较强。这项研究还表明，在正常情况下，IL-1β、IL-6和IL-10仅在人脑细胞外间隙中以极低的浓度存在，甚至根本不存在。结论：这是首次较详细地介绍蛛网膜下腔出血和创伤性脑损伤后IL-1β、IL-6和IL-10的脑反应。3种ILS具有不同的反应模式，IL-1β和IL-6的反应与脑损伤的类型有关，而IL-10的反应变化较小。
BACKGROUND: Microdialysis has become a routine method for biochemical surveillance of patients in neurosurgical intensive care units.OBJECTIVE: To analyze the intracerebral extracellular levels of 3 interleukins (ILs) during the 7 days after major subarachnoid hemorrhage or traumatic brain injury).METHODS: Microdialysate from 145 severely injured neurosurgical intensive care unit patients (88 with subarachnoid hemorrhage, 57 with traumatic brain injury) was collected every 6 hours for 7 days. The concentrations of IL-1 beta and IL-6 were determined by fluorescence multiplex bead technology, and IL-10 was determined by enzyme-linked immunosorbent assay.RESULTS: Presented are the response patterns of 3 ILs during the first week after 2 different types of major brain injury. These patterns are different for each IL and also differ with respect to the kind of pathological impact. For both IL-1 beta and IL-6, the initial peaks (mean values for all patients at day 2 being 26.9 +/- 4.5 and 4399 +/- 848 pg/mL, respectively) were followed by a gradual decline, with IL-6 values remaining 100-fold higher compared with IL-1 beta. Female patients showed a stronger and more sustained response. The response of IL-10 was different, with mean values less than 23 pg/mL and with no significant variation between any of the postimpact days. For all 3 ILs, the responses were stronger in subarachnoid hemorrhage patients. The study also indicates that under normal conditions, IL-1 beta, IL-6, and IL-10 are present only at very low concentrations or not at all in the extracellular space of the human brain.CONCLUSION: This is the first report presenting in some detail the human cerebral response of IL-1 beta, IL-6, and IL-10 after subarachnoid hemorrhage and traumatic brain injury. The 3 ILs have different reaction patterns, with the response of IL-1 beta and IL-6 being related to the type of cerebral damage sustained, whereas the IL-10 response was less varied.