Upregulation of interleukin-1β and interleukin-18 in traumatic brain injury patients and their potential as biomarkers.

BACKGROUND

Traumatic brain injury (TBI) is diagnosed using radiological imaging and biomarker analysis, each with certain limitations. Accurate and accessible detection of TBI is essential for its treatment. Since interleukin (IL)-1β and IL-18 are key neuroinflammatory cytokines, we aim to investigate the regulation of IL-1β and IL-18 in TBI patients and assess their potential as biomarkers of TBI.

METHODS

Forty TBI and 40 healthy subjects were recruited for this study. The Glasgow coma scale (GCS) was used to assess the clinical severity of TBI. Spearman's rank-order correlation was employed to find the association between GCS scores and IL levels of TBI patients. An enzyme-linked immunosorbent assay (ELISA) with human IL-1β and IL-18 ELISA kits was conducted to measure the serum IL-1β and IL-18 levels. The area under the curve (AUC), sensitivity, and specificity were measured to assess the potential of IL-1β and IL-18 as biomarkers.

RESULTS

The patients had mild-to-moderate TBI (mTBI) with a mean GCS score of 11.05 ± 1.67. A negative correlation was found between GCS scores and IL levels, while IL-1 β and IL-18 were positively correlated with each other. IL-1β levels in the TBI and healthy subjects were 1882.19 ± 796.72 pg/mL and 1473.50 ± 333.045 pg/mL, respectively, with a significant difference (p = 0.001). Moreover, the IL-18 levels in TBI subjects (25.92 ± 14.81 ng/L) were also significantly higher (p < 0.001) compared to those of the control group subjects (19.14 ± 2.99 ng/L). The IL-1β exhibited an AUC of 0.72 with 72.5% sensitivity and 70% specificity, at a cut-off point of 1527.25 (pg/mL), while IL-18 had an AUC of 0.78 with 77.5% sensitivity and 72.7% specificity, at a cut-off point of 19.645 (ng/L).

CONCLUSIONS

IL-1β and IL-18 levels were increased remarkably in mTBI patients and exhibited fair potential as biomarkers for the diagnosis and prognosis of TBI.