Plasma interleukin responses as predictors of outcome stratification in patients after major trauma: a prospective observational two centre study.

Autor:	Jones MA; Biomedical Research and Innovation Centre, School of Science, Engineering and Environment, University of Salford, Manchester, United Kingdom., Hanison J; Critical Care Unit, Manchester University National Health Service (NHS) Foundation Trust (MFT), Manchester, United Kingdom., Apreutesei R; Biomedical Research and Innovation Centre, School of Science, Engineering and Environment, University of Salford, Manchester, United Kingdom., Allarakia B; Biomedical Research and Innovation Centre, School of Science, Engineering and Environment, University of Salford, Manchester, United Kingdom., Namvar S; Biomedical Research and Innovation Centre, School of Science, Engineering and Environment, University of Salford, Manchester, United Kingdom.; Faculty of Biology, Medicine and Health, School of Medical Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom., Ramaswamy DS; Biomedical Research and Innovation Centre, School of Science, Engineering and Environment, University of Salford, Manchester, United Kingdom., Horner D; Critical Care Unit, Salford Royal Foundation Trust (SRFT), Salford, United Kingdom.; Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, United Kingdom., Smyth L; Biomedical Research and Innovation Centre, School of Science, Engineering and Environment, University of Salford, Manchester, United Kingdom., Body R; Faculty of Biology, Medicine and Health, School of Medical Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom., Columb M; Critical Care Unit, Manchester University National Health Service (NHS) Foundation Trust (MFT), Manchester, United Kingdom., Nirmalan M; Faculty of Biology, Medicine and Health, School of Medical Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom., Nirmalan N; Biomedical Research and Innovation Centre, School of Science, Engineering and Environment, University of Salford, Manchester, United Kingdom.
Jazyk:	angličtina
Zdroj:	Frontiers in immunology [Front Immunol] 2023 Nov 23; Vol. 14, pp. 1276171. Date of Electronic Publication: 2023 Nov 23 (Print Publication: 2023).
DOI:	10.3389/fimmu.2023.1276171
Abstrakt:	Background and Objectives: There is a need to develop objective risk stratification tools to define efficient care pathways for trauma patients. Biomarker-based point of care testing may strengthen existing clinical tools currently available for this purpose. The dysregulation of pro- and anti-inflammatory cytokines in the pathogenesis of organ failure is well recognised. This study was carried out to evaluate whether blood concentrations of IL-6, IL-10, and IL-6:IL-10 ratios in the early stages of the illness are significantly different in patients with worsening organ function. Materials and Methods: In this prospective observational cohort study, plasma concentrations of IL-6 and IL-10 on days 1, 3 and 5 were measured in 91 major trauma patients using a multiplexed cytometric bead array approach. A composite measure of adverse outcome - defined as SOFA ≥ 2 or mortality at 7 days, was the primary outcome. IL-6 and IL-10 concentrations in early samples (days 1, 3 & 5) in patients who developed SOFA ≥ 2 on day 7 were compared against those who did not. Similar composite outcome groups at day 5 and in groups with worsening or improving SOFA scores (ΔSOFA) at days 7 and 5 were undertaken as secondary analyses. Results: Stratification on day 7, 44 (48%) patients showed adverse outcomes. These adverse outcomes associated with significantly greater IL-6 concentrations on days 1 and 5 (Day 1: 47.65 [23.24-78.68] Vs 73.69 [39.93 - 118.07] pg/mL, P = 0.040 and Day 5: 12.85 [5.80-19.51] Vs 28.90 [8.78-74.08] pg/mL; P = 0.0019). Similarly, IL-10 levels were significantly greater in the adverse outcome group on days 3 and 5 (Day 3: 2.54 [1.76-3.19] Vs 3.16 [2.68-4.21] pg/mL; P = 0.044 and Day 5: 2.03 [1.65-2.55] Vs 2.90 [2.00-5.06] pg/mL; P < 0.001). IL-6 and IL-10 concentrations were also significantly elevated in the adverse outcome groups at day 3 and day 5 when stratified on day 5 outcomes. Both IL-6 and IL-6:IL-10 were found to be significantly elevated on days 1 and 3 when stratified based on ΔSOFA at day 5. This significance was lost when stratified on day 7 scores. Conclusions: Early IL-6 and IL-10 concentrations are significantly greater in patients who develop worsening organ functions downstream. These differences may provide an alternate biomarker-based approach to strengthen risk stratification in trauma patients. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2023 Jones, Hanison, Apreutesei, Allarakia, Namvar, Ramaswamy, Horner, Smyth, Body, Columb, Nirmalan and Nirmalan.)
Databáze:	MEDLINE
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