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@article{1451441,
author = {Ďuriš, Kamil and Neuman, Eduard and Vybíhal, Václav and Juráň, Vilém and Gottwaldová, Jana and Kýr, Michal and Vašků, Anna and Smrčka, Martin},
article_location = {New York},
article_number = {2},
doi = {http://dx.doi.org/10.1055/s-0037-1604084},
keywords = {subarachnoid hemorrhage; early brain injury; inflammation; IL-6},
language = {eng},
issn = {2193-6315},
journal = {Journal of Neurological Surgery, Part A: Central European Neurosurgery},
title = {Early Dynamics of Interleukin-6 in Cerebrospinal Fluid after Aneurysmal Subarachnoid Hemorrhage},
volume = {79},
year = {2018}
}
TY - JOUR
ID - 1451441
AU - Ďuriš, Kamil - Neuman, Eduard - Vybíhal, Václav - Juráň, Vilém - Gottwaldová, Jana - Kýr, Michal - Vašků, Anna - Smrčka, Martin
PY - 2018
TI - Early Dynamics of Interleukin-6 in Cerebrospinal Fluid after Aneurysmal Subarachnoid Hemorrhage
JF - Journal of Neurological Surgery, Part A: Central European Neurosurgery
VL - 79
IS - 2
SP - 145-151
EP - 145-151
PB - Thieme Medical Publ Inc
SN - 21936315
KW - subarachnoid hemorrhage
KW - early brain injury
KW - inflammation
KW - IL-6
N2 - Background Subarachnoid hemorrhage (SAH) is a severe condition associated with high mortality. Early brain injury (EBI) plays an important role in the pathophysiology of SAH, and inflammation is a major contributor to EBI. Inflammation is a widely studied topic in both experimental and clinical conditions; however, just a few clinical studies have focused primarily on the early inflammatory response after SAH, and detailed information about the association between the dynamics of early inflammatory response with main clinical characteristics is lacking. This study analyzes the early dynamics of inflammatory response after SAH and evaluates the possible associations between the markers of early inflammatory response and main clinical characteristics. Patients and Methods A total of 47 patients with a diagnosis of aneurysmal SAH within the last 24 hours were enrolled in the study. All treatments, including treatment of aneurysm (surgery/coiling) and implantation of a drainage system (external ventricular drainage/lumbar catheter), were conducted in the same way as in other patients with this diagnosis. Blood and cerebrospinal fluid (CSF) samples were collected three times a day for 4 days. The dynamics of proinflammatory cytokines were assessed, and associations between levels of the proinflammatory cytokines interleukin (IL)-6, IL-1, or tumor necrosis factor (TNF) and main clinical characteristics were evaluated using linear mixed-effect models. Results The CSF levels of IL-6 were massively increased initially after SAH (up to 72 hours) with an additional increase in later phases (after 72 hours), but there was high variability in IL-6 levels. A significant association was noted between the Glasgow Outcome Scale score and both overall levels of IL-6 ( p =0.0095) and their dynamics ( p =0.0208); the effect of the Hunt and Hess scale was borderline ( p =0.0887). No association was found between IL-6 levels and Fisher grade, modality of treatment (surgery, coiling, no treatment), and later development of cerebral vasospasm. Plasmatic levels of IL-6 increased slightly, but no significant association was found. The levels of IL-1 and TNF were within the physiologic range in both CSF and plasma. Conclusions Early dynamics of IL-6 in CSF are associated with a patient's outcome. But it is difficult to use IL-6 alone for outcome prediction due to its high variability. The question is whether the dynamics of IL-6 could be used in combination with other early markers associated with brain injury. More detailed research is required to answer this question.
ER -
ĎURIŠ, Kamil, Eduard NEUMAN, Václav VYBÍHAL, Vilém JURÁŇ, Jana GOTTWALDOVÁ, Michal KÝR, Anna VAŠKŮ and Martin SMRČKA. Early Dynamics of Interleukin-6 in Cerebrospinal Fluid after Aneurysmal Subarachnoid Hemorrhage. \textit{Journal of Neurological Surgery, Part A: Central European Neurosurgery}. New York: Thieme Medical Publ Inc, 2018, vol.~79, No~2, p.~145-151. ISSN~2193-6315. Available from: https://dx.doi.org/10.1055/s-0037-1604084.
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