Levels of IL-1β, IL-18 and TNF-α in cerebrospinal fluid of aneurysmal subarachnoid hemorrhage patients may be predictors of early brain injury and clinical prognosis.

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Levels of IL-1β, IL-18 and TNF-α in cerebrospinal fluid of aneurysmal subarachnoid hemorrhage patients may be predictors of early brain injury and clinical prognosis.

World Neurosurg. 2017 Dec 19;:

Authors: Lv SY, Wu Q, Liu JP, Shao J, Wen LL, Xue J, Zhang XS, Zhang QR, Zhang X

Abstract
BACKGROUND: Aneurysmal subarachnoid hemorrhage (aSAH) is a severe cerebrovascular accident with high morbidity and mortality. The aim of this study is to investigate the relationship between level of inflammatory cytokines in cerebrospinal fluid of aSAH patients, the severity of aSAH and the outcome of aSAH patients.
METHODS: aSAH patients were prospectively included and followed-up 6 months. CSF samples were collected at 1-3 days, 4-6 days and 7-9 days after aSAH onset, respectively. Levels of IL-1β, IL-18 and TNF-α in the CSF of aSAH patients were measured by enzyme-linked immunosorbent assay.
RESULTS: Eighty-one aSAH patients were enrolled. Levels of IL-1β, IL-18 and TNF-α in CSF were significantly higher in aSAH patients than those of controls at each corresponding period of time (p < 0.05), and these inflammatory cytokines were especially higher in the group of aSAH patients with cerebral edema, cerebral vasospasm and a high grade on Hunt-Hess, the high WFNS scores and the Fisher grade (p < 0.01). Higher level of plasma C-reactive protein in the blood was correlated with poor outcome. The area under the ROC curve (AUC) for the levels of inflammatory cytokines in CSF were 0.85, 0.84 and 0.95, respectively. And clinical features (age, Hunt- Hess grade, etc.) were positively correlated with poor outcomes (p < 0.05).
CONCLUSIONS: The levels of IL-1β, IL-18, TNF-α in the CSF were elevated in aSAH patients and were positively associated with cerebral edema, acute hydrocephalus. Our findings suggested that CSF inflammatory cytokines might be biomarkers to assess severity and predict outcomes.

PMID: 29277532 [PubMed - as supplied by publisher]

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