Background <p>Traumatic brain injury (TBI) is a leading preventable cause of death and disability worldwide. Inflammatory mechanisms contribute to secondary brain injury, and the interleukin-1 (IL-1) cytokine family has emerged as a potential contributor. However, whether circulating IL-1-family cytokines causally influence TBI outcomes remains unknown.</p> Methods <p>We performed a two-sample Mendelian randomization (MR) analysis to evaluate the causal effects of circulating IL-1-family protein levels on TBI outcomes, using inverse-variance weighting (IVW) as the primary analytic method and publicly available genome-wide association study summary statistics.</p> Results <p>Higher genetically predicted circulating IL1RL1 (soluble ST2) levels were associated with an increased risk of unfavorable TBI outcomes (IVW <i>β</i> = 0.22, standard error [SE] = 0.084, <i>P</i> = 0.010), although we were underpowered to test the reverse direction. Sensitivity analyses demonstrated consistent effect estimates with no evidence of horizontal pleiotropy.</p> Conclusions <p>These findings provide genetic evidence that elevated circulating IL1RL1 levels are causally linked to worse TBI outcomes. This suggests the IL-33/IL1RL1 axis as a mechanistically relevant, and potentially modifiable, therapeutic target for improving recovery after TBI.</p>

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Mendelian Randomization Analysis of the IL-1 Cytokine Family Proteins Identifies IL1RL1 as a Potential Causal Contributor to Traumatic Brain Injury Prognosis

  • Youngjune Bhak,
  • Adel Helmy,
  • Edward J Needham,
  • David K Menon,
  • Varun Warrier,
  • Romit J Samanta,
  • Cecilia Åkerlund,
  • Krisztina Amrein,
  • Nada Andelic,
  • Lasse Andreassen,
  • Audny Anke,
  • Anna Antoni,
  • Gérard Audibert,
  • Philippe Azouvi,
  • Maria Luisa Azzolini,
  • Ronald Bartels,
  • Pál Barzó,
  • Romuald Beauvais,
  • Ronny Beer,
  • Bo-Michael Bellander,
  • Antonio Belli,
  • Habib Benali,
  • Maurizio Berardino,
  • Luigi Beretta,
  • Morten Blaabjerg,
  • Peter Bragge,
  • Alexandra Brazinova,
  • Vibeke Brinck,
  • Joanne Brooker,
  • Camilla Brorsson,
  • Andras Buki,
  • Monika Bullinger,
  • Manuel Cabeleira,
  • Alessio Caccioppola,
  • Emiliana Calappi,
  • Maria Rosa Calvi,
  • Peter Cameron,
  • Guillermo Carbayo Lozano,
  • Marco Carbonara,
  • Simona Cavallo,
  • Giorgio Chevallard,
  • Arturo Chieregato,
  • Giuseppe Citerio,
  • Hans Clusmann,
  • Mark Coburn,
  • Jonathan Coles,
  • Jamie D. Cooper,
  • Marta Correia,
  • Amra Čović,
  • Nicola Curry,
  • Endre Czeiter,
  • Marek Czosnyka,
  • Claire Dahyot-Fizelier,
  • Paul Dark,
  • Helen Dawes,
  • Véronique De Keyser,
  • Vincent Degos,
  • Francesco Della Corte,
  • Hugo den Boogert,
  • Bart Depreitere,
  • Đula Đilvesi,
  • Abhishek Dixit,
  • Emma Donoghue,
  • Jens Dreier,
  • Guy-Loup Dulière,
  • Ari Ercole,
  • Patrick Esser,
  • Erzsébet Ezer,
  • Martin Fabricius,
  • Valery L. Feigin,
  • Kelly Foks,
  • Shirin Frisvold,
  • Alex Furmanov,
  • Pablo Gagliardo,
  • Damien Galanaud,
  • Dashiell Gantner,
  • Guoyi Gao,
  • Pradeep George,
  • Alexandre Ghuysen,
  • Lelde Giga,
  • Ben Glocker,
  • Jagoš Golubovic,
  • Pedro A. Gomez,
  • Johannes Gratz,
  • Benjamin Gravesteijn,
  • Francesca Grossi,
  • Russell L. Gruen,
  • Deepak Gupta,
  • Juanita A. Haagsma,
  • Iain Haitsma,
  • Raimund Helbok,
  • Eirik Helseth,
  • Lindsay Horton,
  • Jilske Huijben,
  • Peter J. Hutchinson,
  • Bram Jacobs,
  • Stefan Jankowski,
  • Mike Jarrett,
  • Ji-yao Jiang,
  • Faye Johnson,
  • Kelly Jones,
  • Mladen Karan,
  • Angelos G. Kolias,
  • Erwin Kompanje,
  • Daniel Kondziella,
  • Evgenios Kornaropoulos,
  • Lars-Owe Koskinen,
  • Noémi  Kovács,
  • Ana Kowark,
  • Alfonso Lagares,
  • Linda  Lanyon,
  • Steven Laureys,
  • Fiona Lecky,
  • Didier Ledoux,
  • Rolf  Lefering,
  • Valerie Legrand,
  • Aurelie Lejeune,
  • Leon Levi,
  • Roger Lightfoot,
  • Hester Lingsma,
  • Andrew I. R. Maas,
  • Ana M. Castaño-León,
  • Marc Maegele,
  • Marek Majdan,
  • Alex Manara,
  • Geoffrey Manley,
  • Costanza Martino,
  • Hugues Maréchal,
  • Julia Mattern,
  • Catherine McMahon,
  • Béla Melegh,
  • David Menon,
  • Tomas Menovsky,
  • Ana Mikolic,
  • Benoit Misset,
  • Visakh Muraleedharan,
  • Lynnette Murray,
  • Ancuta Negru,
  • David Nelson,
  • Virginia Newcombe,
  • Daan Nieboer,
  • József Nyirádi,
  • Otesile Olubukola,
  • Matej Oresic,
  • Fabrizio Ortolano,
  • Aarno Palotie,
  • Paul M. Parizel,
  • Jean-François Payen,
  • Natascha Perera,
  • Vincent Perlbarg,
  • Paolo Persona,
  • Wilco Peul,
  • Anna Piippo-Karjalainen,
  • Matti Pirinen,
  • Dana Pisica,
  • Horia Ples,
  • Suzanne Polinder,
  • Inigo Pomposo,
  • Jussi P. Posti,
  • Louis Puybasset,
  • Andreea Radoi,
  • Arminas Ragauskas,
  • Rahul Raj,
  • Malinka Rambadagalla,
  • Isabel Retel Helmrich,
  • Jonathan Rhodes,
  • Sylvia Richardson,
  • Sophie Richter,
  • Samuli Ripatti,
  • Saulius Rocka,
  • Cecilie Roe,
  • Olav Roise,
  • Jonathan Rosand,
  • Jeffrey V. Rosenfeld,
  • Christina Rosenlund,
  • Guy Rosenthal,
  • Rolf Rossaint,
  • Sandra Rossi,
  • Daniel Rueckert,
  • Martin Rusnák,
  • Juan Sahuquillo,
  • Oliver Sakowitz,
  • Renan Sanchez-Porras,
  • Janos Sandor,
  • Nadine Schäfer,
  • Silke Schmidt,
  • Herbert Schoechl,
  • Guus Schoonman,
  • Rico Frederik Schou,
  • Elisabeth Schwendenwein,
  • Charlie Sewalt,
  • Ranjit D. Singh,
  • Toril Skandsen,
  • Peter Smielewski,
  • Abayomi Sorinola,
  • Emmanuel Stamatakis,
  • Simon Stanworth,
  • Robert Stevens,
  • William Stewart,
  • Ewout W. Steyerberg,
  • Nino Stocchetti,
  • Nina Sundström,
  • Riikka Takala,
  • Viktória Tamás,
  • Tomas Tamosuitis,
  • Mark Steven Taylor,
  • Aurore Thibaut,
  • Braden Te  Ao,
  • Olli Tenovuo,
  • Alice Theadom,
  • Matt Thomas,
  • Dick Tibboel,
  • Marjolein Timmers,
  • Christos Tolias,
  • Tony Trapani,
  • Cristina Maria Tudora,
  • Andreas Unterberg,
  • Peter Vajkoczy,
  • Shirley Vallance,
  • Egils Valeinis,
  • Zoltán Vámos,
  • Mathieu van der Jagt,
  • Gregory Van der Steen,
  • Joukje van der Naalt,
  • Jeroen T. J. M. van Dijck,
  • Inge A. M. van Erp,
  • Thomas A. van van Essen,
  • Wim Van Hecke,
  • Caroline van Heugten,
  • Ernest van Veen,
  • Thijs Vande Vyvere,
  • Roel P. J. van Wijk,
  • Alessia Vargiolu,
  • Emmanuel Vega,
  • Kimberley Velt,
  • Jan Verheyden,
  • Paul M. Vespa,
  • Anne Vik,
  • Rimantas Vilcinis,
  • Victor Volovici,
  • Nicole von Steinbüchel,
  • Daphne Voormolen,
  • Petar Vulekovic,
  • Kevin K. W. Wang,
  • Daniel Whitehouse,
  • Eveline Wiegers,
  • Guy Williams,
  • Lindsay Wilson,
  • Stefan Winzeck,
  • Stefan Wolf,
  • Zhihui Yang,
  • Peter Ylén,
  • Alexander Younsi,
  • Marina Zeldovich,
  • Frederick A. Zeiler,
  • Veronika Zelinkova,
  • Agate Ziverte,
  • Tommaso Zoerle

摘要

Background

Traumatic brain injury (TBI) is a leading preventable cause of death and disability worldwide. Inflammatory mechanisms contribute to secondary brain injury, and the interleukin-1 (IL-1) cytokine family has emerged as a potential contributor. However, whether circulating IL-1-family cytokines causally influence TBI outcomes remains unknown.

Methods

We performed a two-sample Mendelian randomization (MR) analysis to evaluate the causal effects of circulating IL-1-family protein levels on TBI outcomes, using inverse-variance weighting (IVW) as the primary analytic method and publicly available genome-wide association study summary statistics.

Results

Higher genetically predicted circulating IL1RL1 (soluble ST2) levels were associated with an increased risk of unfavorable TBI outcomes (IVW β = 0.22, standard error [SE] = 0.084, P = 0.010), although we were underpowered to test the reverse direction. Sensitivity analyses demonstrated consistent effect estimates with no evidence of horizontal pleiotropy.

Conclusions

These findings provide genetic evidence that elevated circulating IL1RL1 levels are causally linked to worse TBI outcomes. This suggests the IL-33/IL1RL1 axis as a mechanistically relevant, and potentially modifiable, therapeutic target for improving recovery after TBI.