Serum IL-8 and MCP-1 Concentration Do Not Identify Patients ... : Journal of Trauma and Acute Care Surgery (original) (raw)

Original Articles

Serum IL-8 and MCP-1 Concentration Do Not Identify Patients With Enlarging Contusions After Traumatic Brain Injury

From the Department of Anaesthesia, Critical Care and Pain Medicine (J.R., P.A.), Western General Hospital, University of Edinburgh, Edinburgh, Scotland; and Translational Medicine Research Collaboration (J.S.), School of Life and Sciences Research, Ninewells Hospital and Medical School, University of Dundee, Dundee, Scotland.

Submitted for publication June 4, 2008.

Accepted for publication November 24, 2008.

Address for reprints: Jonathan Rhodes, MB, ChB, Intensive Care Unit, Western General Hospital, Crewe Road, Edinburgh, Scotland EH4 2XU; email: [email protected].

The Journal of Trauma: Injury, Infection, and Critical Care 66(6):p 1591-1598, June 2009. | DOI: 10.1097/TA.0b013e31819a0344

Abstract

Background:

Cerebral contusions contain numerous leukocytes, and a temporal relationship exists among cerebral chemokine expression, leukocyte recruitment, and contusion enlargement. This would suggest a role for chemokines in contusion development. However, it has not been established if serum concentrations of chemokines such as interleukin-8 (IL-8) or monocyte chemoattractant protein-1 (MCP-1) change with contusion enlargement.

Methods:

Eighteen adult patients with severe contusional traumatic brain injury, on computerized tomography, were identified. Patients with diffuse injuries or extradural and subdural hematomas associated with mass effect were not included in the study. Daily serum samples were taken for the measurement of IL-8 and MCP-1 concentrations for up to 11 days postinjury.

Results:

In the patients who died while in intensive care, IL-8 and MCP-1 were significantly greater than in those patients discharged (18 [0-202] vs. 0 [0-156] pg/mL and 498 [339-1,063] vs. 368 [86-11,289] pg/mL for IL-8 and MCP-1, respectively). No difference was seen in serum chemokine levels in patients who deteriorated with contusion enlargement compared with those that did not. The IL-8 and MCP-1 concentrations did not change significantly over time either in the group as a whole or in the subgroup of patients who deteriorated.

Conclusions:

These inflammatory mediators may be predictive of a poor outcome in patients with traumatic brain injury in which contusions are the predominant abnormality. However, they do not distinguish those patients who will deteriorate because of contusion enlargement.