A pilot study on temporal changes in IL-1β and TNF-α serum levels after spinal cord injury: the serum level of TNF-α in acute SCI patients as a possible marker for neurological remission

Study design: Serum levels of interleukin-1 beta (IL-1 beta) and tumour necrosis factor-alpha (TNF-alpha) were measured over a 12-week period in 23 patients with spinal cord injury (SCI) with and without neurological improvement. Objectives: To determine the course of IL-1 beta and TNF-alpha in patients with SCI and observe a possible relationship between improvements in neurological functioning and cytokine levels. Setting: All patients were treated at the BG Trauma Centre, Ludwigshafen, Germany. All lab work was done at the University Hospital, Heidelberg. Methods: Spinal cord injury was classified according to the American Spinal Injury Association (ASIA) impairment scale (AIS) in 23 patients. TNF-alpha and IL-1 beta levels were measured upon arrival at the hospital, after 4 h, 9 h and 12 h, on days 1 and 3 and at the end of weeks 1, 2, 4, 8 and 12. Results: Temporal changes in TNF-alpha and IL-1 beta in SCI patients were seen. Patients with AIS improvement (Group 1) had significantly lower TNF-alpha levels at 9 h compared with patients without AIS improvement (Group 2; P<0.01). The course of IL-1 beta fluctuated greatly between 4 h and week 1 in the groups; however, between 2 and 12 weeks post trauma, there was an overall decline in both groups. Conclusion: Measuring serum levels of TNF-alpha and IL-1 beta over time could be useful in tracking the course of SCI. Our data show differences in measured cytokines over a 12-week period for SCI patients with and without neurological improvement.