PMID- 20725805
OWN - NLM
STAT- MEDLINE
DCOM- 20110317
LR  - 20220311
IS  - 1556-0961 (Electronic)
IS  - 1541-6933 (Linking)
VI  - 13
IP  - 3
DP  - 2010 Dec
TI  - Relevance of cerebral interleukin-6 after aneurysmal subarachnoid hemorrhage.
PG  - 339-46
LID - 10.1007/s12028-010-9432-4 [doi]
AB  - 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.
FAU - Sarrafzadeh, Asita
AU  - Sarrafzadeh A
AD  - Department of Neurosurgery, Campus Virchow Medical Center, 
      Charite-Universitatsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, 
      Germany. asita.sarrafzadeh@charite.de
FAU - Schlenk, Florian
AU  - Schlenk F
FAU - Gericke, Christine
AU  - Gericke C
FAU - Vajkoczy, Peter
AU  - Vajkoczy P
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Neurocrit Care
JT  - Neurocritical care
JID - 101156086
RN  - 0 (Biomarkers)
RN  - 0 (IL6 protein, human)
RN  - 0 (Interleukin-6)
RN  - 33X04XA5AT (Lactic Acid)
RN  - 8558G7RUTR (Pyruvic Acid)
RN  - 9007-41-4 (C-Reactive Protein)
SB  - IM
MH  - Biomarkers/blood/cerebrospinal fluid
MH  - Brain Ischemia/blood/cerebrospinal fluid/immunology
MH  - C-Reactive Protein/metabolism
MH  - Critical Care/methods
MH  - Encephalitis/*cerebrospinal fluid/*immunology
MH  - Extracellular Fluid/immunology/metabolism
MH  - Female
MH  - Humans
MH  - Interleukin-6/blood/*cerebrospinal fluid
MH  - Lactic Acid/cerebrospinal fluid
MH  - Male
MH  - Microdialysis
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Prospective Studies
MH  - Pyruvic Acid/cerebrospinal fluid
MH  - Subarachnoid Hemorrhage/blood/*cerebrospinal fluid/*immunology
EDAT- 2010/08/21 06:00
MHDA- 2011/03/18 06:00
CRDT- 2010/08/21 06:00
PHST- 2010/08/21 06:00 [entrez]
PHST- 2010/08/21 06:00 [pubmed]
PHST- 2011/03/18 06:00 [medline]
AID - 10.1007/s12028-010-9432-4 [doi]
PST - ppublish
SO  - Neurocrit Care. 2010 Dec;13(3):339-46. doi: 10.1007/s12028-010-9432-4.