• Flávia Mahatma Schneider Soares, Nicole Menezes de Souza, Marcelo Libório Schwarzbold, Alexandre Paim Diaz, Jean Costa Nunes, Alexandre Hohl, Priscilla Nunes Abreu da Silva, Juliana Vieira, Rafael Lisboa de Souza, Melina Moré Bertotti, Rui Daniel Schoder Prediger, Marcelo Neves Linhares, André Bafica, and Roger Walz.
• Centro de Neurociências Aplicadas, Hospital Universitário, Universidade Federal de Santa Catarina, Florianópolis, Brasil.
• Neuroimmunomodulation. 2012 Jan 1;19(6):377-85.

BackgroundCytokines have been shown to be involved in traumatic brain injury (TBI). We investigated the independent association between serum levels of IL-10 and TNF-α and hospital mortality of patients with severe TBI.MethodsSerum IL-10 and TNF-α levels were determined after a median period (interquartile range (IQ) 25-75) of 10 h (IQ 5-18) after severe TBI in 93 consecutive patients and in randomly selected patients with mild (n = 18) and moderate (n = 16) TBI. In patients with severe TBI, additional blood samples were analyzed 30 h (IQ 22-37) and 68 h (IQ 55-78) after TBI. Age, gender, computed tomography findings, Glasgow Coma Scale score (GCS) and pupil reactions at admission, associated trauma and hospital mortality were collected.ResultsElevated serum levels of IL-10, but not TNF-α, correlated significantly with GCS severity (R(2) coefficient, p < 0.0001) and were found to be associated with hospital mortality in patients with severe TBI. Elevated IL-10 remained associated with mortality (p = 0.01) in a subset of patients with isolated severe TBI (n = 74). Multiple logistic regression analysis showed that higher IL-10 levels (>90 pg/ml) at 10 or 30 h after TBI were 6 times (odds ratio (OR) 6.2, 95% confidence interval (CI) 1.2-25.1, p = 0.03) and 5 times (OR 5.4, 95% CI 1.2-25.1, p = 0.03), respectively, more frequently associated with hospital mortality than lower levels (<50 pg/ml), independently of age, GCS as well as pupil reactions at admission and associated trauma.ConclusionsSerum IL-10 levels may be a useful marker for severe TBI prognosis.Copyright © 2012 S. Karger AG, Basel.

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