Background

Chest trauma causes substantial morbidity and mortality and its severity is assessed using clinical diagnosis or scoring systems like Injury severity score (ISS) and thoracic trauma severity score (TTSS). Association of inflammatory cytokines with severity of disease and final clinical outcome is not clearly defined in patients with chest trauma. In this study, we thought to evaluate the inflammatory response in serum and bronchoalveolar lavage fluid (BALF) in chest trauma patients and correlate the level of extracellular cytokines with diseases severity and final outcome.

Methods

A total of 65 patients with blunt chest trauma and 30 healthy controls were enrolled in this prospective observational study. Assessment of inflammatory cytokines such as Interleukin (s) - IL-5, IL-13, IL-2, IL-6, IL-9, IL-1β, IFN-γ, TNF-α, IL-17A, IL-17F,IL-4, IL-21 and IL-22 was performed in both serum and bronchoalveolar lavage fluid using 13-plex multiplex kit using fluorescence–encoded bead based immunoassays.

Results

A significantly higher level of IL-13, IL-2, IL-6, IL-9, IL-1β, IFN-γ, TNF-α, IL-17A, IL-17F, IL-21 and IL-22 cytokines were observed in patients with blunt chest trauma compared to healthy controls. Level of IL-2, IL-6, IL-1β and IL-17A was significantly raised in the patients with blunt chest trauma who had a fatal outcome during the hospital stay. An elevated cytokine response of IL-13, IL-4, and IL-21 was noted in the group of patients with high (>5) thoracic trauma severity score.

Conclusion

Routine monitoring of the inflammatory cytokine level in patients with chest trauma may be used routinely. Longer prospective studies should be encouraged to determine the role of cytokines in patients with chest trauma in predicting the patient final clinical outcome.

中文翻译：

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细胞外细胞因子的变化在预测胸部钝性外伤患者疾病严重程度和最终临床结果中的作用

背景

胸部创伤导致大量发病率和死亡率，其严重程度使用临床诊断或评分系统评估，如损伤严重程度评分 (ISS) 和胸部创伤严重程度评分 (TTSS)。在胸部创伤患者中，炎性细胞因子与疾病严重程度和最终临床结果的关系尚不明确。在这项研究中，我们考虑评估胸部创伤患者血清和支气管肺泡灌洗液 (BALF) 中的炎症反应，并将细胞外细胞因子水平与疾病严重程度和最终结果相关联。

方法

共有 65 名胸部钝器伤患者和 30 名健康对照者参加了这项前瞻性观察性研究。评估炎性细胞因子，例如白细胞介素 - IL-5、IL-13、IL-2、IL-6、IL-9、IL-1β、IFN-γ、TNF-α、IL-17A、IL-17F使用基于荧光编码珠的免疫测定法，使用 13-plex 多重试剂盒在血清和支气管肺泡灌洗液中检测 IL-4、IL-21 和 IL-22。

结果

IL-13、IL-2、IL-6、IL-9、IL-1β、IFN-γ、TNF-α、IL-17A、IL-17F、IL-21 和 IL-22 细胞因子水平显着升高与健康对照组相比，在胸部钝挫伤患者中观察到。在住院期间出现致命结果的钝性胸部创伤患者的IL-2、IL-6、IL-1β和IL-17A水平显着升高。在具有高 (>5) 胸部创伤严重程度评分的患者组中注意到 IL-13、IL-4 和 IL-21 的细胞因子反应升高。

结论

可常规监测胸部外伤患者的炎性细胞因子水平。应鼓励进行更长期的前瞻性研究，以确定胸外伤患者中细胞因子在预测患者最终临床结果中的作用。