High Serum Interleukin-6 Concentration Upon Admission is Predictive of Disease Severity in Paediatric Trauma Patients

Overview

Journal Eur J Trauma Emerg Surg

Specialties Critical Care
Emergency Medicine

Date 2023 Jul 12

PMID 37436468

Authors

Yingge Ma

Yujun Wang

Yanna Yao

Cui Zhang

Qing Tang

Huifang Zhang

Yufei Su

Affiliations

Soon will be listed here.

Abstract

Background: Trauma is the leading cause of death among children worldwide. The inflammatory response of paediatric patients to multiple injuries can be monitored using serum interleukin-6 (IL-6) levels. This study aimed to assess the value of IL-6 levels in predicting the severity of paediatric trauma and its clinical association with disease activity.

Method: We prospectively tested serum IL-6 levels and evaluated the Paediatric Trauma Score (PTS) and other clinical data among 106 paediatrics trauma patients from January 2022 to May 2023 at the Emergency Department of the Xi'an Children's Hospital in China. The relationship between IL-6 and trauma severity levels by PTS was analyzed statistically.

Results: IL-6 levels were elevated in 76 (71.70%) of the 106 paediatric patients with trauma. Spearman's test showed a significant negative linear correlation between IL-6 and PTS (r = - 0.757, p < 0.001). IL-6 levels were moderate positively correlated with alanine aminotransferase, aspartate aminotransferase, white blood cells, blood lactic acid and interleukin 10 (r = 0.513, 0.600, 0.503, 0.417, 0.558, p < 0.01). IL-6 levels were positively correlated with hypersensitive C-reactive protein and glucose (r = 0.377, r = 0.389, respectively, p < 0.001). IL-6 levels were negatively correlated with fibrinogen and PH (r = - 0.434, p < 0.001; r = - 0.382, respectively, p < 0.001). Binary scatter plots further demonstrated higher levels of IL-6 correlated with lower PTS scores.

Conclusion: Serum IL-6 levels significantly increased with increasing severity of paediatric trauma. Serum levels of IL-6 can function as important indicators for predicting disease severity and activity in paediatric trauma patients.

Citing Articles

Vagus nerve stimulation: Novel concept for the treatment of glioblastoma and solid cancers by cytokine (interleukin-6) reduction, attenuating the SASP, enhancing tumor immunity.

Brem S Brain Behav Immun Health. 2024; 42:100859.

PMID: 39512605 PMC: 11541944. DOI: 10.1016/j.bbih.2024.100859.

References

Tanaka T, Narazaki M, Kishimoto T . Interleukin (IL-6) Immunotherapy. Cold Spring Harb Perspect Biol. 2017; 10(8). PMC: 6071487. DOI: 10.1101/cshperspect.a028456. View

Park S, Hwang S . Prognostic Value of Serum Levels of S100 Calcium-Binding Protein B, Neuron-Specific Enolase, and Interleukin-6 in Pediatric Patients with Traumatic Brain Injury. World Neurosurg. 2018; 118:e534-e542. DOI: 10.1016/j.wneu.2018.06.234. View

Martin C, Boisson C, Haccoun M, Thomachot L, Mege J . Patterns of cytokine evolution (tumor necrosis factor-alpha and interleukin-6) after septic shock, hemorrhagic shock, and severe trauma. Crit Care Med. 1997; 25(11):1813-9. DOI: 10.1097/00003246-199711000-00018. View

Qiao Z, Wang W, Yin L, Luo P, Greven J, Horst K . Using IL-6 concentrations in the first 24 h following trauma to predict immunological complications and mortality in trauma patients: a meta-analysis. Eur J Trauma Emerg Surg. 2017; 44(5):679-687. DOI: 10.1007/s00068-017-0880-9. View

Lecuyer M . Calculated Decisions: Pediatric Trauma Score (PTS). Pediatr Emerg Med Pract. 2019; 16(5):CD3-4. View

Nayduch D, Moylan J, Rutledge R, Baker C, Meredith W, Thomason M . Comparison of the ability of adult and pediatric trauma scores to predict pediatric outcome following major trauma. J Trauma. 1991; 31(4):452-7; discussion 457-8. DOI: 10.1097/00005373-199104000-00003. View

Tepas 3rd J, Mollitt D, TALBERT J, Bryant M . The pediatric trauma score as a predictor of injury severity in the injured child. J Pediatr Surg. 1987; 22(1):14-8. DOI: 10.1016/s0022-3468(87)80006-4. View

Saladino R, Lund D, Fleisher G . The spectrum of liver and spleen injuries in children: failure of the pediatric trauma score and clinical signs to predict isolated injuries. Ann Emerg Med. 1991; 20(6):636-40. DOI: 10.1016/s0196-0644(05)82382-0. View

Dinarello C . Historical insights into cytokines. Eur J Immunol. 2007; 37 Suppl 1:S34-45. PMC: 3140102. DOI: 10.1002/eji.200737772. View

10.

Wang X, Wong K, Ouyang W, Rutz S . Targeting IL-10 Family Cytokines for the Treatment of Human Diseases. Cold Spring Harb Perspect Biol. 2017; 11(2). PMC: 6360861. DOI: 10.1101/cshperspect.a028548. View

11.

Hirano T . Interleukin 6 and its receptor: ten years later. Int Rev Immunol. 1998; 16(3-4):249-84. DOI: 10.3109/08830189809042997. View

12.

Kang S, Narazaki M, Metwally H, Kishimoto T . Historical overview of the interleukin-6 family cytokine. J Exp Med. 2020; 217(5). PMC: 7201933. DOI: 10.1084/jem.20190347. View

13.

Erkus S, Turgut A, Kalenderer O . Alterations in serum IL-6 levels in traumatized pediatric patients: A preliminary study for second hit concept. J Orthop Sci. 2021; 27(2):440-447. DOI: 10.1016/j.jos.2020.12.023. View

14.

Jawa R, Anillo S, Huntoon K, Baumann H, Kulaylat M . Interleukin-6 in surgery, trauma, and critical care part II: clinical implications. J Intensive Care Med. 2011; 26(2):73-87. PMC: 6223019. DOI: 10.1177/0885066610384188. View

15.

Paladino L, Subramanian R, Bonilla E, Sinert R . Leukocytosis as prognostic indicator of major injury. West J Emerg Med. 2011; 11(5):450-5. PMC: 3027437. View

16.

Mukama T, Ssemugabo C, Halage A, Gibson D, Paichadze N, Ndejjo R . Costs of unintentional injuries among children in an urban slum community in Kampala city, Uganda. Int J Inj Contr Saf Promot. 2018; 26(2):129-136. DOI: 10.1080/17457300.2018.1515228. View

17.

Ooi S, Spencer R, Hodgson M, Mehta S, Phillips N, Preest G . Interleukin-6 as a prognostic biomarker of clinical outcomes after traumatic brain injury: a systematic review. Neurosurg Rev. 2022; 45(5):3035-3054. PMC: 9256073. DOI: 10.1007/s10143-022-01827-y. View

18.

Barayan D, Abdullahi A, Vinaik R, Knuth C, Auger C, Jeschke M . Interleukin-6 blockade, a potential adjunct therapy for post-burn hypermetabolism. FASEB J. 2021; 35(5):e21596. PMC: 8982752. DOI: 10.1096/fj.202100388R. View