Association of inflammatory cytokines expression in cerebrospinal fluid with the severity and prognosis of spontaneous intracerebral hemorrhage

Abstract

Abstract Objective To investigate the potential diagnostic and prognostic implications of inflammatory cytokine levels in the cerebrospinal fluid (CSF) of Spontaneous intracerebral hemorrhage (SICH) patients upon their initial hospital admission. Methods Our cohort comprised 100 patients diagnosed with acute SICH, who presented to the Department of Neurosurgery. Additionally, 50 individuals, devoid of central nervous system (CNS) pathology and treated concomitantly at our facility, were enlisted as controls. CSF specimens, acquired upon hospital entry, underwent quantitative assessment of 10 inflammatory cytokines employing the Mesoscale Discovery Platform (MSD, Rockville, MD, USA) electrochemiluminescence technology, with subsequent validation via enzyme-linked immunosorbent assay (ELISA). Results Distinct elevation of IL-6, IL-8, IL-10, and TNF-α levels was evident in the CSF of the SICH subgroup relative to controls. Elevated Glasgow Coma Scale (GCS) scores among SICH patients were concomitantly linked with diminished CSF concentrations of IL-6, IL-8, IL-10, and TNF-α, indicating an inverse relationship. Notably, CSF inflammatory cytokine concentrations were consistently elevated in SICH patients manifesting with hydrocephalus compared to those without. Elevations in IL-6, IL-8, IL-10, and TNF-α in the CSF were significantly pronounced in the poor prognosis cohort (Glasgow Outcome Scale, GOS 1–3) relative to their counterparts with a favorable prognosis (GOS 4–5). The AUC values for the aforementioned cytokines in predicting SICH prognosis were 0.750, 0.728, 0.717, and 0.743, respectively. Conclusions The initial CSF levels of IL-6, IL-8, IL-10, and TNF-α upon admission offer significant insights into the severity of neural damage and serve as robust indicators for prognostication in SICH patients.