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In Situ Detection of Inflammatory Mediators in Post Mortem Human Brain Tissue after Traumatic Injury
Abstract
Little is known about the molecular events following severe traumatic brain injury (TBI) in humans and to date there are no efficient therapies for the treatment of patients. In this study, the first of its kind in human tissue, a total of 21 post mortem trauma brain samples were analyzed. The inflammatory response within the brain tissue was explored by measuring the expression of various inflammatory cytokines at the mRNA and protein levels. These mediators were interleukin (IL)-1beta, IL-2, IL-4, IL-6, IL-8, IL-10, tumor necrosis factor (TNF)-alpha, interferon (IFN)-gamma, and granulocyte-macrophage colony-stimulating factor (GM-CSF). This study shows for the first time in human brain tissue that 1) pro-inflammatory mediator protein levels are significantly increased in situ following acute brain injury while anti-inflammatory cytokines protein levels remain unchanged; 2) the cerebral inflammatory response begins within minutes of acute TBI, much earlier than previously thought; 3) IL-6, IL-8, TNF-alpha, and IL-1beta mRNA levels are significantly increased following injury; 4) the rise in cytokine protein level coincides with increased levels of their mRNAs suggesting that traumatic injury elicits an immediate cerebral inflammatory response. Altogether these data confirm and extend previous observations on the release of cytokines in the cerebrospinal fluid of severe TBI patients. Finally, this study highlights the need to characterize the cell source of cytokines and elucidate their mode of action.
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“There are other studies, however, indicating that different types of neuropathology, such as neuroinflammation (36), b-amyloid deposition (37), and accumulation of TDP-43 (38) and p-tau (37, 39, 40) can and do arise following a single moderate-severe TBI (41)(42)(43), and there is emerging evidence that multiple types of neuropathology can be present following repetitive mild TBI (43,44).”
From Mild Chronic Traumatic Encephalopathy Neuropathology in People With No Known Participation in Contact Sports or History of Repetitive Neurotrauma (2019) · cites this paper as [36]
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“Excessive or uncontrolled upregulation can also enhance glutamate release from astrocytes that can lead to glutamate excitotoxicity and blood-brain barrier dysfunction [36,42] via a self-propagating pathological cascade of neuroinflammation and neuronal loss [7], further contributing to the production of multiple down…”
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“For human qPCR experiments, the Ct values were normalised to the geometric mean of Ct values from four housekeeping genes (PPIA, HMBS, UBC, GAPDH) selected on the basis of previous publications [35].”
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“Following TBI, elevation of TNF-a was detected at an early phase in postmortem human brains and diverse experimental models.(50) The release of TNF-a, following acute injury, plays dual and opposing roles, on the one hand enhancing brain damage through the release of neurotoxic substances at acute post-traumatic phase…”
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Lui, A., Kumar, K. K., & Grant, G. (2022) · Frontiers in Toxicology · doi:10.3389/ftox.2022.910972 · Cited by 29
“Parenchymal cells along with microglia in the brain start producing proinflammatory cytokines such as IL-1β, IL-6 and TNF, which leads to the influx of inflammatory cells into the brain, including neutrophils, monocytes/macrophages, and lymphocytes (Ahn et al., 2004; Buttram et al., 2007; Goodman et al., 2008; Lotocki…”
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“In the acute stage of severe adult traumatic brain injury (sTBI), IL-6 and IL-8 show an early increase [8].”
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“It has been well demonstrated that levels of tumor necrosis factor (TNF)-a and interleukin (IL)6 are elevated after TBI [12].”
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Met/HGFR triggers detrimental reactive microglia in TBI
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“There is substantial evidence that interferons are produced and play a mechanistic importance in TBI and spinal cord injury (SCI) (Roselli et al., 2018).”
BackgroundInfluentialNeuroimaging of traumatic brain injury in military personnel: An overview
Bhattrai, A., Andrei Irimia, A., & Horn, J. D. V. (2019) · Journal of Clinical Neuroscience · doi:10.1016/j.jocn.2019.07.001 · Cited by 23
“The levels of these cytokines are higher in the early stages of injury—early as within a few minutes post-trauma—and typically subside over time (79).”
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“A previous study reported markedly higher IL-6 levels in postmortem patients post-injury that led to death.(51) MMP9, a remodeling protein expressed by endothelial cells, was observed.”
ResultImmunity impacts cognitive deficits across neurological disorders
Shaw, B. C., Anders, V., Tinkey, R. A., Habean, M. L., Brock, O. D., Frostino, B. J., & Williams, J. L. (2023) · Journal of Neurochemistry · doi:10.1111/jnc.15999 · Cited by 27
“TNF α transcript is also present in postmortem TBI pa - tient brains that succumbed as early as 17 min post-injury (Frugier et al., 2010 ).”
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“[5,22,25,39,59] Astrogliosis is facilitated by persistent and delayed neuroinflammation, which also attracts macrophages and promotes the activation of local microglia.”
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“…and activation of inflammatory cells (4,19); (iii) increases in the proliferation and reparation of cerebral glial cells in damaged brain regions (5,22); (iv) induction of complications associated with TBI, as well as multiple organ failure, for example, increases in IL-6 have a negative muscle…”
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“The release of pro-inflammatory cytokines and chemokines, such as tumor necrosis factor-alpha (TNF-α ), interleukin-1 beta (IL-1 β ), and interleukin-6 (IL-6), initiates a complex cascade of events that can further damage neuronal cells (Frugier et al. 2010; Hellewell et al. 2016).”
Traumatic Brain Injury in Children: Glial fibrillary Acidic Protein and Clinical Outcomes.
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“Recently, the management of PCS has been directed toward defining subtypes of TBI19 with a targeted approach for a heterogenous the etiology ofmTBI.”
BackgroundInfluentialChuffa, L. G. D. A., Seiva, F. R. F., Silveira, H. S., Cesário, R. C., Tonon, K. D. S., Simão, V. A., Zuccari, D. A. P. D. C., & Reiter, R. J. (2024) · Journal of Cellular Physiology · doi:10.1002/jcp.31383 · Cited by 18
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“2 Immunohistochemistry Human brain paraffin embedded sections (7 μm) were examined to determine the expression and localization of LC3 and SQSTM1 using methods previously described on human postmortem brain tissue (Frugier et al., 2010).”
MethodAbikenari, M. A., Ha, J. H., Liu, J., Ren, A. L., Cho, K. B., Lim, J., Kim, L. H., Medikonda, R. T., Choi, J. H., & Lim, M. K. (2025) · Frontiers in Neurology · doi:10.3389/fneur.2025.1668480 · Cited by 18
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Marjani, S., Zırh, S., Sever, M., Cakir-Aktas, C., Muftuoglu, S. F., & Mut, M. (2021) · Journal of Neuroimmunology · doi:10.1016/j.jneuroim.2021.577672 · Cited by 15
Peptidergic Drugs For the Treatment of Traumatic Brain Injury
Alvarez, X. A., Figueroa, J., & Muresanu, D. F. (2013) · Future Neurology · doi:10.2217/fnl.12.95 · Cited by 17
“Similar elevations of proinflammatory cytokines without upregulation of anti-inflammatory cytokines were also found in post-mortem brain tissue, cerebrospinal fluid (CSF) and blood of TBI patients.([66,67]) Activated microglia have been observed in human TBI brains from 3 days after injury([18]) and, as assessed by PE…”
BackgroundThe role of IL-6 in TBI and PTSD, a potential therapeutic target?
Monsour, M., Croci, D. M., & Agazzi, S. (2022) · Clinical Neurology and Neurosurgery · doi:10.1016/j.clineuro.2022.107280 · Cited by 18
The importance of behavioral interventions in traumatic brain injury
Buccilli, B., Alan, A., Aljeradat, B., Shahzad, A., Almealawy, Y. F., Chisvo, N. S., Ennabe, M., & Weinand, M. E. (2024) · Surgical Neurology International · doi:10.25259/sni_776_2023 · Cited by 14
“[30,34,38,55,68,69,85,88,98] ese secondary injury mechanisms [Figure 1] offer a prolonged therapeutic window to intervene.”
BackgroundKelso, M. L., & Pauly, J. R. (2011) · Progress in molecular biology and translational science · doi:10.1016/b978-0-12-385506-0.00003-x · Cited by 14
Kumari, D., Kaur, S., & Dandekar, M. P. (2024) · ACS Pharmacology & Translational Science · doi:10.1021/acsptsci.4c00310 · Cited by 14
How repetitive traumatic injury alters long-term brain function
Dhillon, N. K., Linaval, N. T., O’Rourke, J. G., Barmparas, G., Yang, A. R., Cho, N., Shelest, O., & Ley, E. J. (2020) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/ta.0000000000002811 · Cited by 13
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“Recent experimental and clinical studies have reported a positive correlation between IL-6 levels and injury severity and prognosis (Tarkowski et al., 1995; Juttler et al., 2002; Woiciechowsky et al., 2002; Minambres, et al., 2003; Frugier et al., 2010; Leyet et al., 2011).”
BackgroundWang, R., Hua, Y., He, M., & Xu, J. (2022) · Journal of Inflammation Research · doi:10.2147/jir.s358621 · Cited by 12
“Finally, the concentration of PCT in CSF which might reflect the degree of neural inflammation was not tested and, therefore, we could not analyze the relationship between serum PCT and CSF PCT.”
Chen, K. S., Noureldein, M. H., McGinley, L. M., Hayes, J. M., Rigan, D. M., Kwentus, J. F., Mason, S. N., Mendelson, F. E., Savelieff, M. G., & Feldman, E. L. (2023) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2023.1306004 · Cited by 14
Göttert, R., Fidzinski, P., Kraus, L., Schneider, U. C., Holtkamp, M., Endres, M., Gertz, K., & Kronenberg, G. (2021) · PubMed · doi:10.17169/refubium-36739 · Cited by 12
Neuroprotective Potential of Bacopa monnieri: Modulation of Inflammatory Signals
Reale, M., Costantini, E., Jarlapoodi, S., Serra, F., Aielli, L., Khan, H. Z., Belwal, T., & Falasca, K. (2022) · CNS & Neurological Disorders - Drug Targets · doi:10.2174/1871527321666220111124047 · Cited by 11
Effects of Current Psychotropic Drugs on Inflammation and Immune System
Bhatt, S., Dhar, A. K., Samanta, M. K., & Suttee, A. (2023) · Advances in experimental medicine and biology · doi:10.1007/978-981-19-7376-5_18 · Cited by 12
ŞAKUL, A. A., Balçıkanlı, Z., Ateş, N., Orhan, C., Şahin, N., Tuzcu, M., Juturu, V., Kılıç, E., & Şahin, K. (2024) · Chemical Biology & Drug Design · doi:10.1111/cbdd.14439 · Cited by 11
“In the study, curcumin formulations decreased IL-6 levels, which, while undetectable in a healthy brain, become upregulated and secreted after TBI (Frugier et al., 2010).”
BackgroundHsueh, S., Parekh, P., Batsaikhan, B., Vargesson, N., Tweedie, D., Luo, W., Patel, C., Liu, D., McDevitt, R. A., Baig, A. M., et al. (2025) · Journal of Biomedical Science · doi:10.1186/s12929-025-01150-w · Cited by 10
Bingham, D., John, C. M., Levin, J., Panter, S. S., & Jarvis, G. A. (2013) · Journal of Neuroimmunology · doi:10.1016/j.jneuroim.2012.12.009 · Cited by 11
“Previous in situ analyses of human brain tissue post mortem after TBI for protein and mRNA of inflammatory cytokines including IL-2, IL-4, IL-6, IL-8, IFN-γ, GM-CSF, and TNF-α showed increased levels within minutes and significant elevations after 6 h which persisted for days (Frugier et al., 2010).”
Gorgun, M. F., Zhuo, M., Cortez, I., Dineley, K. T., & Englander, E. W. (2017) · Inhalation Toxicology · doi:10.1080/08958378.2018.1432728 · Cited by 10
“…remained unchanged, suggesting that delayed manifestations of smoke inhalation, do not involve acute inflammatory responses that are typically associated with marked increases in IL-6 levels (Frugier et al., 2010; Yin et al., 2017), but rather are consistent with chronic inflammatory condition.”
BackgroundNeuroimmune activation is associated with neurological outcome in anoxic and traumatic coma
Sarton, B., Tauber, C., Fridman, E. A., Péran, P., Riu, B., Vinour, H., David, A., Geeraerts, T., Bounes, F. V., Minville, V., et al. (2024) · Brain · doi:10.1093/brain/awae045 · Cited by 13
“…thalamic accumulation and activation of glial cells has been re-ported in post-mortem specimens from patients who died from either acute traumatic 11 or anoxic 12 brain injury, and animal models studies have identified early inflammatory processes in both traumatic 13 and anoxic 14 conditions,…”
The kynurenine pathway in traumatic brain injuries and concussion
Dehhaghi, M., Heng, B., & Guillemin, G. J. (2023) · Frontiers in Neurology · doi:10.3389/fneur.2023.1210453 · Cited by 10
“It has been previously reported that the levels of pro-inflammatory molecules, particularly IL-6, IFN-γ, TNF-α, and GM-CSF, are significantly increased in TBI within early minutes of injury, suggesting an immediate inflammatory response (50).”
BackgroundSharkey, J. M., Quarrington, R., Krieg, J. L., Kaukas, L., Turner, R., Leonard, A., Jones, C. F., & Corrigan, F. (2023) · Brain Research · doi:10.1016/j.brainres.2023.148475 · Cited by 9
“This contrasts with the increased pro-inflammatory cytokines previously reported following all severities of TBI both clinically and experimentally (Goodman et al., 1990; Feuerstein et al., 1998; Frugier et al., 2010; Di Battista et al., 2016; Baratz et al., 2015).”
Drug- and cell-based therapies for targeting neuroinflammation in traumatic brain injury
Borlongan, C., Kaelber, S., & Pantcheva, P. (2016) · Neural Regeneration Research · doi:10.4103/1673-5374.193231 · Cited by 10
“Following the acute injury, activity of pro-inflammatory cytokines interleukin (IL)-1 and IL-6 rise, followed by increases in tumor necrosis factor (TNF), IL-6, IL-8, IL-10, transforming growth factor beta (TGF-β) in the ensuing weeks after injury (Frugier et al., 2010).”
BackgroundInfluentialSajanti, A., Hellström, S., Bennett, C., Srinath, A., Jhaveri, A., Cao, Y. J., Takala, R. S. K., Frantzén, J., Koskimäki, F., Falter, J., et al. (2024) · Inflammation · doi:10.1007/s10753-024-02185-1 · Cited by 9
“TNFα and IL-1β were included because they are widely studied inflammatory molecules, well-known for their significant roles in mediating neuro-inflammation and neuronal damage [25–33].”
Wang, Y., Jia, W., Zhu, J., Xu, R., & Lin, Y. (2022) · Chinese Chemical Letters · doi:10.1016/j.cclet.2022.107746 · Cited by 9
Effects of antifibrinolytics on systemic and cerebral inflammation after traumatic brain injury
Wallen, T. E., Singer, K. E., Baucom, M. R., England, L. G., Schuster, R. M., Pritts, T. A., & Goodman, M. D. (2022) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/ta.0000000000003607 · Cited by 9
Cederberg, D., Visse, E., Marklund, N., & Siesjö, P. (2023) · Journal of Neuroimmunology · doi:10.1016/j.jneuroim.2023.578020 · Cited by 9
Baker, T. L., Sun, M., Semple, B. D., Tyebji, S., Tonkin, C. J., Mychasiuk, R., & Shultz, S. R. (2020) · Journal of Neuroinflammation · doi:10.1186/s12974-020-01885-3 · Cited by 11
Usmanov, E. S., Chubarova, M. A., & Saidov, S. K. (2020) · Современные технологии в медицине · doi:10.17691/stm2020.12.5.11 · Cited by 8
“Release of intracellular DNA and dying cell debris into the extracellular space and secretion of additional damage-associated molecular patterns trigger production of pro-inflammatory cytokines (increased levels of TNF, INF-γ, and IL-6) [46, 47].”
BackgroundChiollaz, A.-C., Pouillard, V., Habre, C., Seiler, M., Romano, F., Spigariol, F., Schenk, C. R., Korff, C. M., Maréchal, F., Wyss, V., et al. (2024) · Frontiers in Neurology · doi:10.3389/fneur.2024.1432217 · Cited by 8
“Together with IL6, IL8 has been found to be increased in the acute stage of severe adult TBI (17).”
BackgroundHsueh, S., Scerba, M. T., Tweedie, D., Lecca, D., Kim, D. S., Baig, A. M., Kim, Y. K., Hwang, I., Kim, S., Selman, W. R., et al. (2022) · Biomedicines · doi:10.3390/biomedicines10102449 · Cited by 8
“Within minutes to hours after TBI, the mRNA and protein expressions of TNF-α are elevated in patients [37,38] and pre-clinical animal models [39,40], occurring before the presence of other cytokines and enhancing the process of leukocyte infiltration to the local injury site [41].”
BackgroundCandy, S., Ma, I., McMahon, J. M., Farrell, M., & Mychasiuk, R. (2017) · Brain Injury · doi:10.1080/02699052.2017.1363407 · Cited by 8
“A similar temporal profile is seen in terms of microglial activation, astrogliosis and axonal damage (31).”
BackgroundThe Role of Cytokine Gene Polymorphisms in Rehabilitation Outcome After Traumatic Brain Injury
Guerini, F. R., Agliardi, C., Zanzottera, M., Caronni, A., Antolini, L., Derchi, C., Atzori, T., Bolognesi, E., Navarro, J., Clerici, M., et al. (2025) · Cells · doi:10.3390/cells14141056 · Cited by 7
“To this end, we analyzed a panel of SNPs in the TNF-α , IL-6 , IL-6 receptor, IL-1 β , and IL-10 genes-cytokines suggested to be involved in the pathophysiology of TBI [16,17]- in patients diagnosed with subacute TBI who were enrolled in an intensive rehabilitation program.”
Metadata
- Authors
- Frugier, T., Morganti-Kossmann, M. C., O'Reilly, D., & McLean, C. A.
- Affiliations
- The Alfred Hospital (AU)
- National Trauma Research Institute, The Alfred Hospital and Department of Medicine Monash University, Melbourne, Victoria, Australia.
- Corresponding author
- Frugier, Tony
- Venue
- Journal of Neurotrauma
- Publisher
- SAGE Publications
- Published
- 2010-03
- Volume
- 27
- Issue
- 3
- Pages
- 497-507
- ISSN
- 0897-7151 (ISSN-L)
- 1557-9042
- OpenAlex
- W2084674974
- Cited by
- 278
- References
- 50
- Citations by year
- 2026: 9 · 2025: 15 · 2024: 21 · 2023: 12 · 2022: 20 · 2021: 23 · 2020: 25 · 2019: 22 · 2018: 16 · 2017: 21 · 2016: 15 · 2015: 15 · 2014: 24 · 2013: 19 · 2012: 14
- FWCI
- 4.47
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Neurotrauma (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
- Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
- Keywords
- traumatic brain injury, neuroinflammation, inflammatory cytokines, postmortem brain, interleukin-6, interleukin-8, TNF-α, IL-1β, cytokine mRNA expression, human brain
- MeSH terms
- Adolescent, Adult, Aged, Brain, Brain Injuries, Diagnosis, Encephalitis, Female, Humans, Interferon-gamma, Interleukins, Male, Middle Aged, RNA, Messenger, Tumor Necrosis Factor-alpha, Biomarkers, Granulocyte-Macrophage Colony-Stimulating Factor, Cytokines, Inflammation Mediators, Young Adult
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