Chiollaz Anne-Cécile, Pouillard Virginie, Habre Céline, Seiler Michelle, Romano Fabrizio, Spigariol Fabian, Ritter Schenk Céline, Korff Christian, Maréchal Fabienne, Wyss Verena, Gruaz Lyssia, Montaner Joan, Manzano Sergio, Sanchez Jean-Charles
Department of Internal Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Pediatric Neurology Unit, Department of the Woman, Child and Adolescent, Geneva University Hospitals, Geneva, Switzerland.
Front Neurol. 2024 Jul 11;15:1432217. doi: 10.3389/fneur.2024.1432217. eCollection 2024.
Inflammatory biomarkers, as indicators of biological states, provide a valuable approach for accurate and reproducible measurements, crucial for the effective management of mild traumatic brain injury (mTBI) in pediatric patients. This study aims to assess the diagnostic utility of blood-based inflammatory markers IL6, IL8, and IL10 in children with mTBI, including those who did not undergo computed tomography (CT) scans.
A prospective multicentric cohort study involving 285 pediatric mTBI patients was conducted, stratified into CT-scanned and non-CT-scanned groups within 24 h post-trauma, alongside 74 control subjects. Biomarker levels were quantitatively analyzed using ELISA. Sensitivity and specificity metrics were calculated to determine the diagnostic efficacy of each biomarker.
A total of 223 mTBI patients (78%) did not undergo CT scan examination but were kept in observation for symptoms monitoring at the emergency department (ED) for more than 6 h (in-hospital-observation patients). Among CT-scanned patients ( = 62), 14 (23%) were positive (CT+). Elevated levels of IL6 and IL10 were found in mTBI children compared to controls. Within mTBI patients, IL6 was significantly increased in CT+ patients compared to both CT- and in-hospital-observation patients. No significant differences were observed for IL8 among the compared groups. IL6 yielded a specificity of 48% in identifying CT- and in-hospital-observation patients, with 100% sensitivity in excluding all CT+ cases. These performances were maintained whether IL6 was measured within 6 h or within 24 h after the trauma.
The inflammatory marker IL6 emerges as a robust biomarker, showing promising stratification value for pediatric mTBI patients undergoing CT scans or staying in observation in a pediatric ED.
炎症生物标志物作为生物状态的指标，为准确且可重复的测量提供了一种有价值的方法，这对于小儿轻度创伤性脑损伤（mTBI）的有效管理至关重要。本研究旨在评估血液炎症标志物白细胞介素6（IL6）、白细胞介素8（IL8）和白细胞介素10（IL10）在小儿mTBI患者中的诊断效用，包括那些未接受计算机断层扫描（CT）的患者。
进行了一项前瞻性多中心队列研究，纳入285例小儿mTBI患者，在创伤后24小时内分为CT扫描组和非CT扫描组，同时纳入74例对照受试者。使用酶联免疫吸附测定法（ELISA）对生物标志物水平进行定量分析。计算敏感性和特异性指标以确定每种生物标志物的诊断效能。
共有223例mTBI患者（78%）未接受CT扫描检查，但在急诊科（ED）接受症状监测观察超过6小时（院内观察患者）。在CT扫描患者（n = 62）中，14例（23%）呈阳性（CT +）。与对照组相比，mTBI患儿的IL6和IL10水平升高。在mTBI患者中，与CT -和院内观察患者相比，CT +患者的IL6显著升高。在比较的组中，IL8未观察到显著差异。IL6在识别CT -和院内观察患者时特异性为48%，在排除所有CT +病例时敏感性为100%。无论在创伤后6小时内还是24小时内测量IL6，这些性能均保持不变。
炎症标志物IL6是一种强大的生物标志物，对于接受CT扫描或在小儿急诊科观察的小儿mTBI患者显示出有前景的分层价值。
