Plasma profiles of inflammatory cytokines in children with moderate to severe traumatic brain injury: a prospective cohort study

作者全名："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"

作者地址："[Huang, Haixin; Lu, Siwei; Chen, Song; Huo, Junming; Ran, Yunni; Xiao, Changxue; Chen, Jian; Pi, Dandan; Zhou, Fang; Dang, Hongxing; Liu, Chengjun; Fu, Yue-qiang] Chongqing Med Univ, Dept Crit Care Med, Childrens Hosp, Chongqing 400014, Peoples R China; [Fu, Guo] Chongqing Med Univ, Ctr Clin Mol Med, Childrens Hosp, Chongqing 400014, Peoples R China; [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] Natl Clin Res Ctr Child Hlth & Disorders, Chongqing 400014, Peoples R China; [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] Minist Educ, Key Lab Child Dev & Disorders, Chongqing 400014, Peoples R China"

通信作者："Fu, YQ (通讯作者)，Chongqing Med Univ, Dept Crit Care Med, Childrens Hosp, Chongqing 400014, Peoples R China.; Fu, YQ (通讯作者)，Natl Clin Res Ctr Child Hlth & Disorders, Chongqing 400014, Peoples R China.; Fu, YQ (通讯作者)，Minist Educ, Key Lab Child Dev & Disorders, Chongqing 400014, Peoples R China."

来源：EUROPEAN JOURNAL OF PEDIATRICS

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001223451300001

JCR分区：Q1

影响因子：3.6

年份：2024

卷号：183

期号：8

开始页：3359

结束页：3368

文献类型：Article

关键词：Traumatic brain injury; Cytokines; Inflammation; Mortality

摘要："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)-1 beta, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-17A, interferon (IFN)-alpha, IFN-gamma and tumor necrosis factor (TNF)-alpha 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-1 beta, IL-2, IL-4, IL-10, IL-12p70, IL-17A, IFN-gamma, IFN-alpha and TNF-alpha 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:center dot Inflammation is an important secondary physiological response to TBI.What is New:center dot 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."

基金机构：Program for Youth Innovation in Future Medicine from Chongqing Medical University: Basic and Clinical Study of Critical Illness in Children

基金资助正文：We would like to acknowledge the patients and parents who participated in this study and the nurses who drew blood samples.