J Korean Soc Emerg Med.  2003 Oct;14(4):415-424.

Relationship of Interleukin-4, 6, 10, 12 and Tumor Necrosis Factor-alpha Serum Levels to Severity of Injury and Clinical Outcome in Trauma Patients

• Ryu SY
• Jin HC
• Noh JY
• Kim HY
• Han SW
• Kim KW
• Kim SJ
• Han TH

Abstract

PURPOSE
Trauma has been recognized to be accompanied by alterations of leukocyte, functions such as cytokine release. The regulatory mechanisms involved in these changes are still poorly defined. The aims of this prospective clinical study are to evaluate serum concentrations of cytokines in trauma patients with high risk of developing multiple organ failure, to investigate early change, and to examine the possible prognostic value of these elements.
METHODS
Thirty-two patients with multiple traumatic injuries were studied. Patients were classified by age, sex, vector, Injury Severity Score (ISS), Triage Revised Trauma Score (T-RTS), and Systemic Inflammatory Response Syndrome (SIRS). Patients were categorized into two groups, depending on the severity of injury. Group 1 (n=21) consisted of patients with severe injuries and an ISS equal to or greater than 17 points. Group 2 (n=11) consisted of patients with minor injuries and an ISS less than 17 points. Whole blood and serum were obtained immediately after admission to the emergency department, and on days 1 and 3 after trauma. The post-traumatic serum levels of TNF-alpha, IL-4, IL-6, IL-10, and IL-12 were monitored using an enzyme-linked immunosorbent assay technique (ELISA).
RESULTS
The 32 severely injured patients had a mean Injury Severity Score of 19.28+/-7.35 points. SIRS developed in 24 patients. Serum levels of IL-6, IL-10, and TNF-alpha were increased immediately and at 1 day and 3 days after the trauma, but the levels of IL-4 and IL-12 were not changed. Serum levels of IL-4, IL-6, IL-10, IL-12, and TNF-alpha were not related to the severity of the injury. However, the serum level of IL-10 was significantly increased at admission and on day 1 in patients who died (p<0.05 ).
CONCLUSION
Serum IL-6, IL-10, and TNF-alpha levels were affected by injury. However, their levels did not correlate with the degree of injury. The serum level of IL-10 was significantly increased at admission and on day 1 in patients who died.

Keyword

Trauma; Cytokine; ISS; SIRS

MeSH Terms

Cytokines
Emergency Service, Hospital
Enzyme-Linked Immunosorbent Assay
Humans
Injury Severity Score
Interleukin-10
Interleukin-12
Interleukin-4*
Interleukin-6
Leukocytes
Multiple Organ Failure
Prospective Studies
Systemic Inflammatory Response Syndrome
Triage
Tumor Necrosis Factor-alpha*
Cytokines
Interleukin-10
Interleukin-12
Interleukin-4
Interleukin-6
Tumor Necrosis Factor-alpha