Clinical Value of Inflammatory Cytokines in Patients with Aneurysmal Subarachnoid Hemorrhage

Clin Interv Aging. 2022 Apr 26:17:615-626. doi: 10.2147/CIA.S362854. eCollection 2022.

Abstract

Background: Inflammation is closely associated with prognosis in patients with aneurysmal subarachnoid hemorrhage (aSAH), which is orchestrated by inflammatory cytokines. Therefore, this study aimed to investigate the levels of inflammatory cytokines in the early stage of aSAH and their predictive value for prognosis.

Methods: In this retrospective study, 206 patients with aSAH were recruited and assigned to a severe group (WFNS grade ≥ 4) and a mild group (WFNS grade < 4) according to the severity of patients on admission. Flow cytometry was performed to detect the levels of 12 inflammatory cytokines in the serum of patients. Then, patients were grouped into a poor prognosis group (mRS score ≥ 4) and a good prognosis group (mRS score < 4) based on their prognosis after 3 months of discharge to compare the relationship between cytokines and prognosis. Propensity score matching (PSM) was utilized to control confounding factors. The correlation between inflammatory factors and prognosis was determined using Spearman correlation, and the predictive efficacy of inflammatory factors was tested by a receiver operating characteristic curve.

Results: Serum IL-1β, IL-5, IL-6, IL-8, IL-10, IFN-γ, and TNF-α levels were significantly higher in the mild group than in the severe group and in the poor prognosis group than in the good prognosis group. After PSM, the differences in IL-1β, IL-5, IFN-α, and IFN-γ levels disappeared between the two groups, whereas IL-2, IL-6, IL-8, IL-10, and TNF-α levels remained higher in the poor prognosis group than in the good prognosis group. Additionally, IL-2, IL-6, IL-8, and IL-10 levels were positively correlated with mRS scores. Moreover, the predictive value was found to be the highest for IL-6 and the lowest for TNF-α.

Conclusion: Inflammation degree was related to the severity of aSAH. Inflammatory markers, including IL-6, IL-10, IL-8, IL-2, and TNF-α, might predict the poor prognosis of aSAH.

Keywords: aneurysmal subarachnoid hemorrhage; cytokine; inflammation; prognosis; propensity score matching.

MeSH terms

  • Cytokines
  • Humans
  • Inflammation / complications
  • Interleukin-10
  • Interleukin-2
  • Interleukin-5
  • Interleukin-6
  • Interleukin-8
  • Retrospective Studies
  • Subarachnoid Hemorrhage* / complications
  • Subarachnoid Hemorrhage* / diagnosis
  • Tumor Necrosis Factor-alpha

Substances

  • Cytokines
  • Interleukin-2
  • Interleukin-5
  • Interleukin-6
  • Interleukin-8
  • Tumor Necrosis Factor-alpha
  • Interleukin-10

Grants and funding

The work is funded by The opening Project of Provincial key Laboratory of Colleges and Universities in Jiangsu Province (XZSYSKF2020010); The Youth Medical Science and Technology Innovation Project of Xuzhou Municipal Health Commission (XWKYHT20200001); The Science and Technology Development Fund Project of the affiliated Hospital of Xuzhou Medical University in 2020 (XYFZ2020008).