Treatment with an interleukin-1 receptor antagonist mitigates neuroinflammation and brain damage after polytrauma

Traumatic brain injury (TBI) and long bone fracture are common in polytrauma. This injury combination in mice results in elevated levels of the pro-inflammatory cytokine interleukin-1p (IL-18) and exacerbated neuropathology when compared to isolated-TBI. Here we examined the effect of treatment with an IL-1 receptor antagonist (IL-1ra) in mice given a TBI and a concomitant tibial fracture (i.e., poly trauma). Adult male C57BL/6 mice were given sham-injuries or polytrauma and treated with saline vehicle or IL-lra (100 mg/1<g). Treatments were subcutaneously injected at 1,6, and 24 h, and then once daily for one week post-injury. 7-8 mice/group were euthanized at 48 h post-injury. 12-16 mice/group underwent behavioral testing at 12 weeks post-injury and MRI at 14 weeks post-injury before being euthanized at 16 weeks post-injury. At 48 h post-injury, markers for activated microglia and astrocytes, as well as neutrophils and edema, were decreased in polytrauma mice treated with IL-lra compared to polytrauma mice treated with vehicle. At 14 weeks post-injury, MRI analysis demonstrated that IL-1 ra treatment after polytrauma reduced volumetric loss in the injured cortex and mitigated track weighted MRI markers for axonal injury. As IL-1 ra (Anakinra) is approved for human use, it may represent a promising therapy in polytrauma cases involving TBI and fracture. Crown Copyright (C) 2017 Published by Elsevier Inc. All rights reserved.