| Relevance of cerebral interleukin-6 after aneurysmal subarachnoid hemorrhage. | |
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MedLine Citation:
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PMID: 20725805 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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BACKGROUND: This study examines the inflammatory response via interleukin-6 (IL-6) in aneurysmal subarachnoid hemorrhage (aSAH) patients and its association with their clinical course (occurrence of acute focal neurological deficits, AFND; and delayed cerebral ischemia, DCI). METHODS: A total of 38 consecutive aSAH patients were studied prospectively within 14 days after admission and classified as asymptomatic (n = 9; WFNS grade 1 (1-2), median and quartiles) and symptomatic (n = 29; WFNS grade 4 (2-5)); the latter presenting with AFND (n = 13), DCI (n = 10) or both (n = 6). Levels of pro-inflammatory cytokine IL-6 were determined in cerebral extracellular fluid (ECF, using cerebral microdialysis), cerebrospinal fluid (CSF) and plasma for 10 days after aSAH. Additionally, C-reactive protein (CRP) levels were measured in plasma. RESULTS: High IL-6 levels in CSF, ECF and plasma were found in all patients, reflecting a pronounced local inflammatory response after aSAH, followed only in symptomatic patients by a delayed systemic inflammation (CRP P < 0.025, days 7-9 after aSAH). In all compartments, IL-6 levels appeared to be higher in symptomatic patients, accompanied also by a higher ECF lactate-pyruvate ratio (P = 0.04). Cerebral, but not plasma IL-6, levels were indicative of the development of DCI in symptomatic patients (ECF P = 0.003; CSF P = 0.001). CONCLUSIONS: A pronounced initial cerebral inflammatory state was observed in patients of all WFNS grades, suggesting that IL-6 elevations are not necessarily detrimental. Cerebral, but not plasma IL-6, levels were predictive of the development of delayed ischemic deficits in symptomatic patients, suggesting that CSF or ECF are the best sampling media for future studies. |
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Authors:
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Asita Sarrafzadeh; Florian Schlenk; Christine Gericke; Peter Vajkoczy |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Neurocritical care Volume: 13 ISSN: 1556-0961 ISO Abbreviation: Neurocrit Care Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-11-26 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101156086 Medline TA: Neurocrit Care Country: United States |
Other Details:
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Languages: eng Pagination: 339-46 Citation Subset: IM |
Affiliation:
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Department of Neurosurgery, Campus Virchow Medical Center, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany. asita.sarrafzadeh@charite.de |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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