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Diagnostic potential of IL6 and other blood-based inflammatory biomarkers in mild traumatic brain injury among children - PubMed

  • ️Mon Jan 01 2024

Diagnostic potential of IL6 and other blood-based inflammatory biomarkers in mild traumatic brain injury among children

Anne-Cécile Chiollaz et al. Front Neurol. 2024.

Abstract

Objectives: Inflammatory biomarkers, as indicators of biological states, provide a valuable approach for accurate and reproducible measurements, crucial for the effective management of mild traumatic brain injury (mTBI) in pediatric patients. This study aims to assess the diagnostic utility of blood-based inflammatory markers IL6, IL8, and IL10 in children with mTBI, including those who did not undergo computed tomography (CT) scans.

Methods: A prospective multicentric cohort study involving 285 pediatric mTBI patients was conducted, stratified into CT-scanned and non-CT-scanned groups within 24 h post-trauma, alongside 74 control subjects. Biomarker levels were quantitatively analyzed using ELISA. Sensitivity and specificity metrics were calculated to determine the diagnostic efficacy of each biomarker.

Results: A total of 223 mTBI patients (78%) did not undergo CT scan examination but were kept in observation for symptoms monitoring at the emergency department (ED) for more than 6 h (in-hospital-observation patients). Among CT-scanned patients (n = 62), 14 (23%) were positive (CT+). Elevated levels of IL6 and IL10 were found in mTBI children compared to controls. Within mTBI patients, IL6 was significantly increased in CT+ patients compared to both CT- and in-hospital-observation patients. No significant differences were observed for IL8 among the compared groups. IL6 yielded a specificity of 48% in identifying CT- and in-hospital-observation patients, with 100% sensitivity in excluding all CT+ cases. These performances were maintained whether IL6 was measured within 6 h or within 24 h after the trauma.

Conclusion: The inflammatory marker IL6 emerges as a robust biomarker, showing promising stratification value for pediatric mTBI patients undergoing CT scans or staying in observation in a pediatric ED.

Keywords: biomarkers; cytokines; diagnosis; emergency; mild traumatic brain injury (mTBI); pediatric.

Copyright © 2024 Chiollaz, Pouillard, Habre, Seiler, Romano, Spigariol, Ritter Schenk, Korff, Maréchal, Wyss, Gruaz, Montaner, Manzano and Sanchez.

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Conflict of interest statement

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.

Figures

Figure 1
Figure 1

Cytokines serum concentration in mTBI patients (within 24 h). (A) Biomarkers expression within CT- or in-hospital-observation patients and CT+ mTBI patients (CT-scanned and observed without CT [>6 h at ED] patients). (B) Biomarkers expression within CT- and CT+ mTBI patients (only CT-scanned patients). Positive CT is based on PECARN criteria. Box plots represent median and IQR for compared groups; dot plots represent for each patient log scaled biomarker’s concentration. The analysis was carried out using a Mann–Whitney U test (shown p-value).

Figure 2
Figure 2

Cytokines diagnostic performances to classify mTBI patients (within 24 h). (A) Diagnostic performances within CT- or in-hospital-observation patients and CT+ mTBI patients (CT-scanned and observed without CT [>6 h at ED] patients). (B) Diagnostic performances within CT- and CT+ mTBI patients (only CT-scanned patients). Receiver Operating Characteristic (ROC) Curves in mTBI patients. AUC = Area Under the Curve with 95% confidence interval. Performances were investigated at 100% sensitivity and corresponding highest specificity (black round on ROC curve).

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Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This study was supported by a private grant from the Geneva University Hospitals (HUG) for its first year of recruitment. Open access funding by University of Geneva.