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A Dynamic and Complex Early Inflammatory Response in Blood and Cerebrospinal Fluid of Severe Traumatic Brain Injury Patients : A Dual Platform Analysis

Persson, Oskar W. LU orcid ; Ruscher, Karsten LU ; Uvelius, Erik LU and Marklund, Niklas LU orcid (2026) In Inflammation 49(1).
Abstract
Severe traumatic brain injury (TBI) is associated with high mortality and long-term disability. Inflammation is central to TBI pathophysiology, yet early dynamics of inflammatory mediators in blood and cerebrospinal fluid (CSF) remain incompletely understood, and commonly used assay platforms have rarely been directly compared. We aimed to characterize the inflammatory response in blood and CSF during the first week after severe TBI and to assess agreement between electrochemiluminescence (ECL) and proximity extension assay (PEA). In this prospective observational study, adults with severe TBI (n = 21) were recruited. Plasma and CSF samples were collected at two time points: days 1–3 and days 4–8. Orthopedic patients with minor extremity... (More)
Severe traumatic brain injury (TBI) is associated with high mortality and long-term disability. Inflammation is central to TBI pathophysiology, yet early dynamics of inflammatory mediators in blood and cerebrospinal fluid (CSF) remain incompletely understood, and commonly used assay platforms have rarely been directly compared. We aimed to characterize the inflammatory response in blood and CSF during the first week after severe TBI and to assess agreement between electrochemiluminescence (ECL) and proximity extension assay (PEA). In this prospective observational study, adults with severe TBI (n = 21) were recruited. Plasma and CSF samples were collected at two time points: days 1–3 and days 4–8. Orthopedic patients with minor extremity fractures (n = 11) served as controls. Inflammatory mediator levels were quantified using ECL (11 mediators) and PEA (45 mediators). Group differences, temporal changes, and inter-platform agreement were analyzed. In plasma, 13 mediators were increased and 3 decreased, while in CSF, 19 were increased and 3 decreased during the first week post-injury. Key mediators (IL-6, IL-8, IL-10) were consistently elevated in both compartments. When comparing analytic methods, ECL and PEA showed strong cross-platform correlations for IL-8 and IL-10 in both plasma and CSF, whereas IL-13 showed weak, non-significant correlation. However, limited interchangeability between platforms and platform-related differences across compartments and time points were also observed. Severe TBI is associated with marked, temporal and compartmentalized inflammatory response during first post-injury, particularly in CSF. Comparison of ECL and PEA showed limited interchangeability, underscoring the importance of platform awareness and interpretation in TBI biomarker studies. Clinical trial number: Not applicable. (Less)
Please use this url to cite or link to this publication:
author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Acute Inflammation, traumatic brain injury, Inflammation, Electrochemiluminescence, Proximity extension assay, Cytokines, Cerebrospinal fluid
in
Inflammation
volume
49
issue
1
article number
156
pages
19 pages
publisher
Springer
external identifiers
  • scopus:105042791346
ISSN
1573-2576
DOI
10.1007/s10753-026-02549-9
language
English
LU publication?
yes
id
ba1d919f-2985-4fee-ae36-2a45f52fd818
date added to LUP
2026-06-26 09:44:03
date last changed
2026-07-19 04:01:21
@article{ba1d919f-2985-4fee-ae36-2a45f52fd818,
  abstract     = {{Severe traumatic brain injury (TBI) is associated with high mortality and long-term disability. Inflammation is central to TBI pathophysiology, yet early dynamics of inflammatory mediators in blood and cerebrospinal fluid (CSF) remain incompletely understood, and commonly used assay platforms have rarely been directly compared. We aimed to characterize the inflammatory response in blood and CSF during the first week after severe TBI and to assess agreement between electrochemiluminescence (ECL) and proximity extension assay (PEA). In this prospective observational study, adults with severe TBI (n = 21) were recruited. Plasma and CSF samples were collected at two time points: days 1–3 and days 4–8. Orthopedic patients with minor extremity fractures (n = 11) served as controls. Inflammatory mediator levels were quantified using ECL (11 mediators) and PEA (45 mediators). Group differences, temporal changes, and inter-platform agreement were analyzed. In plasma, 13 mediators were increased and 3 decreased, while in CSF, 19 were increased and 3 decreased during the first week post-injury. Key mediators (IL-6, IL-8, IL-10) were consistently elevated in both compartments. When comparing analytic methods, ECL and PEA showed strong cross-platform correlations for IL-8 and IL-10 in both plasma and CSF, whereas IL-13 showed weak, non-significant correlation. However, limited interchangeability between platforms and platform-related differences across compartments and time points were also observed. Severe TBI is associated with marked, temporal and compartmentalized inflammatory response during first post-injury, particularly in CSF. Comparison of ECL and PEA showed limited interchangeability, underscoring the importance of platform awareness and interpretation in TBI biomarker studies. Clinical trial number: Not applicable.}},
  author       = {{Persson, Oskar W. and Ruscher, Karsten and Uvelius, Erik and Marklund, Niklas}},
  issn         = {{1573-2576}},
  keywords     = {{Acute Inflammation; traumatic brain injury; Inflammation; Electrochemiluminescence; Proximity extension assay; Cytokines; Cerebrospinal fluid}},
  language     = {{eng}},
  month        = {{06}},
  number       = {{1}},
  publisher    = {{Springer}},
  series       = {{Inflammation}},
  title        = {{A Dynamic and Complex Early Inflammatory Response in Blood and Cerebrospinal Fluid of Severe Traumatic Brain Injury Patients : A Dual Platform Analysis}},
  url          = {{http://dx.doi.org/10.1007/s10753-026-02549-9}},
  doi          = {{10.1007/s10753-026-02549-9}},
  volume       = {{49}},
  year         = {{2026}},
}