Tumor necrosis factor-mediated inhibition of interleukin-18 in the brain: a clinical and experimental study in head-injured patients and in a murine model of closed head injury.

Table 1 Clinical data and intrathecal cytokine levels in patients with severe closed head injury.

Patient	Age (years) / Gender	Type of brain injury (Marshall score)	Outcome (GOS)	TNF in CSF (pg/mL)		IL-18 in CSF (pg/mL)		Correlation r _S
				Mean	Range	Mean	Range
1	38 / M	EML	4	6.4	1.0 – 11.5	40.6	6.5 – 155.2	- 0.804 **
2	30 / M	DI II°	3	3.6	1.0 – 7.7	114.3	29.7 – 286.4	- 0.580 *
3	56 / M	EML	4	6.3	1.0 – 10.0	35.1	11.2 – 100.3	- 0.530
4	57 / F	DI II°	5	6.0	1.0 – 11.7	20.1	5.0 – 168.8	- 0.761 **
5	44 / M	EML	4	1.6	1.0 – 3.4	39.8	22.6 – 74.5	- 0.751 *
6	26 / M	EML	4	3.2	1.0 – 10.3	108.5	5.0 – 328.6	- 0.832 **
7	47 / M	EML	1	1.1	1.0 – 1.4	268.5	78.3 – 462.0	- 0.372
8	25 / M	EML	4	2.2	1.0 – 4.0	91.6	10.3 – 290.0	- 0.195
9	37 / F	DI III°	3	1.6	1.0 – 2.7	183.7	21.5 – 382.2	- 0.844 **
10	35 / M	DI II°	4	2.0	1.0 – 5.8	209.4	19.9 – 391.8	- 0.772 *
Controls	( n = 10)			1.0	1.0 – 7.1	5.0	5.0 – 8.4

Statistical analysis for assessment of the correlation between tumor necrosis factor (TNF) and interleukin (IL)-18 levels in serial cerebrospinal fluid samples for up to 14 days after trauma was performed by Spearman's rank correlation (*P < 0.05, **P < 0.01). The patients' outcome was determined at 3 months after injury by the Glasgow Outcome Scale (GOS) score [33]: 5 = asymptomatic, 4 = moderate disability, 3 = severe disability, 2 = persisting vegetative state, 1 = death. The type of brain injury was classified by the CT-scan criteria established by Marshall et al. [34] into diffuse injury (DI) grade I-III and evacuated vs. non-evacuated mass lesions (EML, NEML).

ISSN: 1742-2094