Interleukin-6 and Interleukin-10 concentrations as predictors of patient outcome following major traumatic injury

Jones, MA 2017, Interleukin-6 and Interleukin-10 concentrations as predictors of patient outcome following major traumatic injury , MSc by research thesis, University of Salford.

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Abstract

Trauma is one of the main causes of death worldwide, accounting for 4.8 million deaths per year. This death rate has led to trauma being classed as the top cause of death for males, aged between fifteen and twenty-nine. More recently, however, the pattern of major trauma is reported to be changing, with elderly cohorts and falls from less than 2 meters emerging as the dominant presenting complaint. In addition to these deaths, directly caused in the early phase following major trauma, a second peak of deaths resulting from the complications including sepsis and multiple organ failure, occurs in the days and weeks following the initial traumatic insult.

These complications develop due to an imbalance between the pro-inflammatory and antiinflammatory response to traumatic injury. This imbalance results in the counter inflammatory response becoming dominant. This results in complications including sepsis and multi-organ failure occurring due to the resultant immunosuppression. Thus, the ability to monitor the pro- and anti-inflammatory responses through the measurement of interleukin-6 and interleukin-10, may allow an early prediction of patient outcome and the likelihood of developing complications.

Blood samples and clinical data were taken on days 1, 3 and 5, with additional clinical data taken on day 8, following admission. Patient blood serum was analysed for their interleukin- 6 and interleukin-10 concentrations, using cytometric bead arrays, in sequential samples, over a five-day period following traumatic injury.

The concentrations of interleukin-6 and interleukin-10 for these patients were then compared to their clinical data and scoring systems. This evaluated the use of interleukin-6 or interleukin-10 as potential biomarkers for the early detection of complications and poor clinical outcome following trauma. Metabolomic analysis was also conducted in parallel to validate methodology and identify new molecules and pathways involved in the response to trauma.

Interleukin-10 concentration was further utilised to cluster liquid chromatography/mass spectrometry metabolomic analysis to identify significant metabolites that are higher in patients with elevated interleukin-10.

Preliminary results show that both interleukin-6 and interleukin-10 differentiate between good and poor outcome. Median interleukin-6 concentrations were found to be at their peak in day 1 (54.28 pg/ml ± 214.48), decreasing in day 3 (29.43 pg/ml ± 300.19) and further decreasing in day 5 (10.90 pg/ml ± 673.74). A similar pattern was observed following analysis for interleukin-10 with the peak on day 1 (5.87 pg/ml ± 20.21), decreasing in day 3 (2.59 pg/ml ± 4.96) and decreasing further in day 5 (1.99 pg/ml ± 8.82). Furthermore, Day 1 interleukin-10 concentrations were used to cluster the metabolomic analysis. With this grouping, a significant change in penicillin based antibiotic metabolites was observed in day 5 metabolomic analysis of trauma patient’s serum samples, identifying day 1 interleukin-10 a predictive marker for the need for long term antibiotic usage.

This study indicates that the balance between interleukin-6 and interleukin-10 has potential predictive value for the early detection of complications following trauma and provide early guidance towards optimal therapeutic intervention.

Item Type: Thesis (MSc by research)
Schools: Schools > School of Environment and Life Sciences > Biomedical Research Centre
Depositing User: Matthew Allan Jones
Date Deposited: 23 Feb 2018 14:44
Last Modified: 04 Jun 2018 15:02
URI: http://usir.salford.ac.uk/id/eprint/43970

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