Interleukin-6 as a prognostic biomarker of clinical outcomes after traumatic brain injury: a systematic review

Ooi, Setthasorn Zhi Yang, Spencer, Robert J., Hodgson, Megan, Mehta, Samay, Phillips, Nicholas Lloyd, Priest, Gwilym, Manivannan, Susruta, Wise, Matt P., Galea, James and Zaben, Malik ORCID: https://orcid.org/0000-0002-7446-4532 2022. Interleukin-6 as a prognostic biomarker of clinical outcomes after traumatic brain injury: a systematic review. Neurosurgical Review 45 , pp. 3035-3054. 10.1007/s10143-022-01827-y

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Abstract

Background Traumatic brain injury (TBI) is a major cause of mortality and morbidity worldwide. There are currently no early biomarkers for prognosis in routine clinical use. Interleukin-6 (IL-6) is a potential biomarker in the context of the established role of neuroinflammation in TBI recovery. Therefore, a systematic review of the literature was performed to assess and summarise the evidence for IL-6 secretion representing a useful biomarker for clinical outcome. Methods A multi-database literature search between January 1946 and July 2021 was performed. Studies were included if they reported adult TBI patients with IL-6 concentration in serum, cerebrospinal fluid (CSF) and/or brain parenchyma analysed with respect to functional outcome and/or mortality. A synthesis without meta-analysis is reported. Results 15 studies were included, reporting 699 patients. Most patients were male (71.7%) and the pooled mean age was 40.8 years. 78.1% sustained severe TBI. Eleven studies reported IL-6 levels in serum, six in CSF and one in parenchyma. Five studies on serum demonstrated higher IL-6 concentrations were associated with poorer outcomes and five showed no signification association. In CSF studies, one found higher IL-6 levels were associated with poorer outcome, one found them to predict better outcomes, and three found no association. Greater parenchymal IL-6 was associated with better outcomes. Conclusion Despite some inconsistency in findings, it appears that exaggerated IL-6 secretion predicts poor outcomes after TBI. Future efforts require standardisation of IL-6 measurement practices as well as assessment of the importance of IL-6 concentration dynamics with respect to clinical outcomes, ideally within large prospective studies. Prospero registration number CRD42021271200

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine Neuroscience and Mental Health Research Institute (NMHRI)
Subjects:	R Medicine > RZ Other systems of medicine
Additional Information:	This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.
Publisher:	Springer
ISSN:	0344-5607
Date of First Compliant Deposit:	23 June 2022
Date of Acceptance:	12 June 2022
Last Modified:	06 Jan 2024 03:36
URI:	https://orca.cardiff.ac.uk/id/eprint/150581

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