Faculty of Kinesiology & Physical Education, University of Toronto, 55 Harbord St., Toronto, ON, M5S 2W6, Canada.
Defence Research and Development Canada, Toronto Research Centre, Toronto, ON, Canada.
BMC Immunol. 2020 Mar 12;21(1):11. doi: 10.1186/s12865-020-0339-3.
Inflammation appears to be an important component of concussion pathophysiology. However, its relationship to symptom burden is unclear. Therefore, the purpose of this study was to evaluate the relationship between symptoms and inflammatory biomarkers measured in the blood of male and female athletes following a sport-related concussion (SRC).
Forty athletes (n = 20 male, n = 20 female) from nine interuniversity sport teams at a single institution provided blood samples within one week of an SRC. Twenty inflammatory biomarkers were quantitated by immunoassay. The Sport Concussion Assessment Tool version 5 (SCAT-5) was used to evaluate symptoms. Partial least squares (PLS) analyses were used to evaluate the relationship(s) between biomarkers and symptoms. In males, a positive correlation between interferon (IFN)-γ and symptom severity was observed following SRC. The relationship between IFN-γ and symptoms was significant among all symptom clusters, with cognitive symptoms displaying the largest effect. In females, a significant negative relationship was observed between symptom severity and cytokines IFN-γ, tumor necrosis factor (TNF)-α, and myeloperoxidase (MPO); a positive relationship was observed between symptom severity and MCP-4. Inflammatory mediators were significantly associated with all symptom clusters in females; the somatic symptom cluster displayed the largest effect.
These results provide supportive evidence of a divergent relationship between inflammation and symptom burden in male and female athletes following SRC. Future investigations should be cognizant of the potentially sex-specific pathophysiology underlying symptom presentation.
炎症似乎是脑震荡病理生理学的一个重要组成部分。然而，其与症状负担的关系尚不清楚。因此，本研究的目的是评估男性和女性运动员在运动相关脑震荡（SRC）后血液中测量的炎症生物标志物与症状之间的关系。
来自单一机构的九支校际运动队的 40 名运动员（n=20 名男性，n=20 名女性）在 SRC 后一周内提供了血液样本。通过免疫测定定量了 20 种炎症生物标志物。使用运动性脑震荡评估工具 5 版（SCAT-5）评估症状。偏最小二乘法（PLS）分析用于评估生物标志物与症状之间的关系。在男性中，SRC 后 IFN-γ与症状严重程度呈正相关。IFN-γ与症状之间的关系在所有症状群中均具有统计学意义，认知症状的影响最大。在女性中，观察到症状严重程度与细胞因子 IFN-γ、肿瘤坏死因子（TNF）-α和髓过氧化物酶（MPO）之间存在显著负相关；症状严重程度与 MCP-4 之间存在正相关。炎症介质与女性所有症状群均显著相关；躯体症状群的影响最大。
这些结果为 SRC 后男性和女性运动员的炎症与症状负担之间存在发散关系提供了支持性证据。未来的研究应意识到潜在的性别特异性症状表现的病理生理学。
