- •Most TBI events are mild and brain damage may not be seen with standard CT imaging.
- •Serum IL-10 measurement can be used as a predictive marker of CT positivity.
- •Performance was highest in patients sampled within 90 min of trauma.
- •Maximum performance was found for patients between 36 and 66 years-old.
- •Point-of-care testing of IL-10 may help in triage of mild TBI for optimum outcomes.
Blood-based biomarkers were recently proposed as predictors of traumatic brain injury (TBI) outcomes. This would be a critical step forward since the majority of TBI events are mild and structural brain damage in this group may be missed by current brain imaging methods. We sought to determine the performance of early measurement of interleukin-10 (IL-10) to distinguish computed tomography (CT)-positive from negative patients with mild TBI. We designed a single-center prospective observational study, which enrolled consecutive patients classed with mild TBI according to Glasgow Coma Scale [GCS] scores and appearance of at least one clinical symptom. Serum IL-10 levels were measured <3 h post hospital admission. The performance of IL-10 levels in correctly classifying patients was evaluated. IL-10 levels were significantly higher in the group with positive CT scans (p < 0.001). With sensitivity set at 100%, the specificity of IL-10 was only 38.1%. However, the specificities of IL-10 for prediction of negative and positive cases increased to 59% and 49%, respectively, when both parameters were assessed within 90 min of admission. For mild TBI patients between 36 and 66 years, classification performance increased significantly at the 100% sensitivity level with a specificity of 93%. Our results suggest that IL-10 may be an easily accessible clinically useful diagnostic biomarker that can distinguish between mild TBI patients with and without structural brain damage with higher effectiveness when lower times of blood sampling are employed and patients are between 36 and 66 years of age.
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- Moderate and severe traumatic brain injury in adults.Lancet Neurol. 2008; 7: 728-741
- A systematic review of care needs of people with traumatic brain injury (TBI) on a cognitive, emotional and behavioural level.J. Clin. Nurs. 2010; 19: 1198-1206
- Neurobehavioral consequences of traumatic brain injury.Mount Sinai J. Med. New York. 2006; 73: 999-1005
- The impact of traumatic brain injuries: a global perspective.NeuroRehabilitation. 2007; 22: 341-353
- Estimating the global incidence of traumatic brain injury.J. Neurosurg. 2018; 1-18
- Epidemiology of traumatic brain injury.Handb. Clin. Neurol. 2015; 127: 3-13
- Effect of the modified Glasgow coma scale score criteria for mild traumatic brain injury on mortality prediction: comparing classic and modified Glasgow coma scale score model scores of 13.J. Trauma. 2011; 71 (discussion 93.): 1185-1192
- Clinical trials in head injury.J. Neurotrauma. 2002; 19: 503-557
- Glasgow coma scale scoring is often inaccurate.Prehospital Disast. Med. 2015; 30: 46-53
- Predicting outcome after traumatic brain injury: development and international validation of prognostic scores based on admission characteristics.PLoS Med. 2008; 5 (discussion e)e165
- Rapid analytical methods for on-site triage for traumatic brain injury.Annu Rev Anal Chem (Palo Alto, Calif). 2012; 5: 35-56
- Early measurement of interleukin-10 predicts the absence of CT scan lesions in mild traumatic brain injury.PLoS One. 2018; 13e0193278
- CT overuse for mild traumatic brain injury.Jt. Comm. J. Qual. Patient Saf. 2012; 38: 483-489
- Blood-based biomarkers for prediction of intracranial hemorrhage and outcome in patients with moderate or severe traumatic brain injury.J. Trauma Acute Care Surg. 2020; 89: 80-86
- A literature review of traumatic brain injury biomarkers.Mol. Neurobiol. 2022; 59: 4141-4158
- A blood-based biomarker panel to risk-stratify mild traumatic brain injury.PLoS One. 2017; 12e0173798
- Acute inflammation in traumatic brain injury and Polytrauma patients using network analysis.Shock (Augusta, Ga). 2020; 53: 24-34
- Clinical evidence of inflammation driving secondary brain injury: a systematic review.J. Trauma Acute Care Surg. 2015; 78: 184-191
- The role of markers of inflammation in traumatic brain injury.Front. Neurol. 2013; 4: 18
- IL-10 levels in cerebrospinal fluid and serum of patients with severe traumatic brain injury: relationship to IL-6, TNF-alpha, TGF-beta1 and blood-brain barrier function.J. Neuroimmunol. 1999; 101: 211-221
- Interleukin 10 and heart fatty acid-binding protein as early outcome predictors in patients with traumatic brain injury.Front. Neurol. 2020; 11: 376
- The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies.J. Clin. Epidemiol. 2008; 61: 344-349
- Studies of selective TNF inhibitors in the treatment of brain injury from stroke and trauma: a review of the evidence to date.Drug Design Dev. Ther. 2014; 8: 2221-2238
- Pathological vascular and inflammatory biomarkers of acute- and chronic-phase traumatic brain injury.Concussion (London, England). 2017; 2Cnc30
- Mitochondria dysfunction and inflammation in traumatic brain injury: androgens to the battlefront.Androg. Clin. Res. Therap. 2021; 2: 304-315
- Fluid biomarkers of traumatic brain injury and intended context of use.Diagnostics (Basel, Switzerland). 2016; 6
- Network pharmacology identifies IL6 as an important hub and target of tibolone for drug repurposing in traumatic brain injury.Biomed. Pharmacother. 2021; 140111769
- Pathologic patterns of interleukin 10 expression--a review.Biochem. Med. 2015; 25: 36-48
- Raising the bar for traumatic brain injury biomarker research: methods make a difference.J. Neurotrauma. 2017; 34: 2187-2189
- Time course and diagnostic accuracy of glial and neuronal blood biomarkers GFAP and UCH-L1 in a large cohort of trauma patients with and without mild traumatic brain injury.JAMA Neurol. 2016; 73: 551-560
- Glial fibrillary acidic protein and ubiquitin C-terminal hydrolase-L1 are not specific biomarkers for mild CT-negative traumatic brain injury.J. Neurotrauma. 2017; https://doi.org/10.1089/neu.2016.4442
- Combining H-FABP and GFAP increases the capacity to differentiate between CT-positive and CT-negative patients with mild traumatic brain injury.PLoS One. 2018; 13e0200394
- Admission levels of interleukin 10 and amyloid β 1–40 improve the outcome prediction performance of the Helsinki computed tomography score in traumatic brain injury.Front. Neurol. 2020; : 11
- Potential of heart fatty-acid binding protein, neurofilament light, interleukin-10 and S100 calcium-binding protein B in the acute diagnostics and severity assessment of traumatic brain injury.Emerg. Med. J. EMJ. 2022; 39: 206-212
- Serum Neurofilament light is elevated differentially in older adults with uncomplicated mild traumatic brain injuries.J. Neurotrauma. 2019; 36: 2400-2406
- Diagnostic procedures in mild traumatic brain injury: results of the WHO Collaborating Centre task force on mild traumatic brain injury.J. Rehabil. Med. 2004; 43 Suppl: 61-75
- Scandinavian guidelines for initial management of minimal, mild, and moderate head injuries. The Scandinavian Neurotrauma committee.J. Trauma. 2000; 48: 760-766
- Lab-on-a-Chip device for rapid measurement of vitamin D levels.Methods Mol. Biol. 2018; 1735: 477-486
- Lab-on-a-Chip proteomic assays for psychiatric disorders.Adv. Exp. Med. Biol. 2017; 974: 339-349
Published online: January 21, 2023
Accepted: January 19, 2023
Received in revised form: January 10, 2023
Received: November 8, 2022
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