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Pagkou D, Kogias E, Foroglou N, Kotzampassi K. Probiotics in Traumatic Brain Injury: New Insights into Mechanisms and Future Perspectives. J Clin Med 2024; 13:4546. [PMID: 39124812 PMCID: PMC11313054 DOI: 10.3390/jcm13154546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Revised: 07/19/2024] [Accepted: 07/30/2024] [Indexed: 08/12/2024] Open
Abstract
Traumatic brain injury (TBI) is a serious global public health issue, recognized as a chronic and progressive disease that can affect multiple organs, including the gastrointestinal (GI) tract. Research shows that there is a specific link between the GI tract and the central nervous system, termed the gut-brain axis, which consists of bidirectional exchange between these two. Several preclinical and clinical studies have demonstrated intestinal barrier dysfunction, intestinal inflammation and gut dysbiosis in patients with TBI. It is proven that probiotics can modulate the inflammatory process and modify gut microbiota. Numerous animal studies and human clinical trials have proven the effectiveness of selected bacterial strains as an adjuvant treatment in reducing inflammation, infection rates and time spent in intensive care of hospitalized patients suffering from brain injury. Thus, this review summarizes the current evidence regarding the beneficial effects of probiotic administration in patients suffering from TBI-related complications. This review will help identify novel therapeutic strategies in the future as probiotics have an extensive history of apparently safe use.
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Affiliation(s)
- Diamantoula Pagkou
- Department of Neurosurgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Kiriakidi 1, 54636 Thessaloniki, Greece; (E.K.); (N.F.)
| | - Evangelos Kogias
- Department of Neurosurgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Kiriakidi 1, 54636 Thessaloniki, Greece; (E.K.); (N.F.)
| | - Nikolaos Foroglou
- Department of Neurosurgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Kiriakidi 1, 54636 Thessaloniki, Greece; (E.K.); (N.F.)
| | - Katerina Kotzampassi
- Department of Surgery, Aristotle University of Thessaloniki, Kiriakidi 1, 54636 Thessaloniki, Greece;
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Kuhne LA, Ksiezarczyk AM, Braumann KM, Reer R, Jacobs T, Röder B, Hötting K. Cardiovascular exercise, learning, memory, and cytokines: Results of a ten-week randomized controlled training study in young adults. Biol Psychol 2023; 176:108466. [PMID: 36455805 DOI: 10.1016/j.biopsycho.2022.108466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 11/11/2022] [Accepted: 11/23/2022] [Indexed: 11/29/2022]
Abstract
Physical exercise has been shown to enhance memory and to increase neuroplasticity. Rodent studies have revealed modulating effects of signaling molecules of the immune system (cytokines) on hippocampal plasticity and memory. Acute and chronic exercise have been both found to alter the number and function of immune cells. Thus, physical exercise might enhance neuroplasticity via an altered immune response. In this study we tested whether multiple repetitions of a vocabulary learning task combined with a bout of cardiovascular exercise enhances learning in humans and whether memory improvements correlated with acute exercise-induced cytokine changes. Data of 52 participants (20-40 years of age) who were randomly assigned to a cardiovascular exercise group (cycling) or a control group (stretching) were analyzed. During the 10-week treatment, participants completed 18 learning-exercise sessions. In each of these sessions, the vocabulary learning task was always performed immediately before exercising started. To assess acute exercise-induced changes in cytokine levels, blood sampling was performed at rest and immediately after exercising in two of the sessions. Learning success measured as increase in learning across all sessions and vocabulary retention four weeks after the treatment had ended did not differ between groups. The cycling group showed a relatively larger acute increase in IL-6, IL-1ra, IL-4, and IFN-γ compared to the stretching group. Exploratory analyses revealed significant positive associations between within-session learning and acute exercise-induced increases in IL-6 and IL-1ra in the cycling group only. These results suggest that the immune system may act as a mediator of exercise-induced cognitive benefits.
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Affiliation(s)
- Laura A Kuhne
- Biological Psychology and Neuropsychology, University of Hamburg, Von-Melle-Park 11, 20146 Hamburg, Germany.
| | | | | | - Rüdiger Reer
- Sports and Exercise Medicine, University of Hamburg, Turmweg 2, 20148 Hamburg, Germany.
| | - Thomas Jacobs
- Protozoa Immunology, Bernhard Nocht Institute for Tropical Medicine, Bernhard-Nocht-Straße 74, 20359 Hamburg, Germany.
| | - Brigitte Röder
- Biological Psychology and Neuropsychology, University of Hamburg, Von-Melle-Park 11, 20146 Hamburg, Germany.
| | - Kirsten Hötting
- Biological Psychology and Neuropsychology, University of Hamburg, Von-Melle-Park 11, 20146 Hamburg, Germany.
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Wang M, Gao F, Ni S, Song Y, Wang C, Li Q, Zhao P. Electrochemical immunosensor based on gold-thionine for detection of subarachnoid hemorrhage biomarker. Front Bioeng Biotechnol 2023; 11:1153987. [PMID: 36970612 PMCID: PMC10030515 DOI: 10.3389/fbioe.2023.1153987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 02/17/2023] [Indexed: 03/29/2023] Open
Abstract
Introduction: In clinical work, the realization of an early diagnosis of Subarachnoid hemorrhage (SAH) is primarily based on conventional computed tomography (CT), MR angiography, transcranial Doppler (TCD) ultrasound, and neurological assessments. However, the association between imaging manifestations and clinical findings is insufficiently perfect, particularly in SAH patients in acute phases with a lower amount of blood. The establishment of a direct, rapid and ultra-sensitive detection method based on electrochemical biosensors has emerged as a new competitive challenge in disease biomarkers research. Methods: In this study, a novel free-labeled electrochemical immunosensor for rapidly and sensitively detecting IL-6 in subarachnoid hemorrhage (SAH) blood has been developed using Au nanospheres-thionine composites (AuNPs/THI) as the interface modified on the electrode. Then, we detected IL-6 in blood samples from SAH patients by (enzyme-linked immunosorbent assay) ELISA and electrochemical immunosensor. Results: Under the best conditions, the developed electrochemical immunosensor exhibited a wide linear range from 10-2 ng/mL to 102 ng/mL with a low detection limit of 1.85 pg/mL. Furthermore, when the immunosensor was employed in the analysis of IL-6 in 100% serum, the results obtained by electrochemical immunoassay were consistent with those obtained by ELISA without suffering from other significant biological interference. Discussion: The designed electrochemical immunosensor realizes the detection of IL-6 in actual serum samples with high accuracy and sensitivity, and could potentially become a promising technique for applications in the clinical diagnosis of SAH.
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Affiliation(s)
- Mengyue Wang
- The Second Affiliated Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong, China
| | - Feng Gao
- The Second Affiliated Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong, China
| | - Shoujie Ni
- The Second Affiliated Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong, China
| | - Yanan Song
- The Second Affiliated Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong, China
- Qingdao Medical College of Qingdao University, Qingdao, Shandong, China
| | - Cai Wang
- The Second Affiliated Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong, China
| | - Qian Li
- The Second Affiliated Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong, China
| | - Peng Zhao
- The Second Affiliated Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong, China
- *Correspondence: Peng Zhao,
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Liu X, Zhang G, Wei P, Zhong L, Chen Y, Zhang J, Chen X, Zhou L. 3D-printed collagen/chitosan/secretome derived from HUCMSCs scaffolds for efficient neural network reconstruction in canines with traumatic brain injury. Regen Biomater 2022; 9:rbac043. [PMID: 35855109 PMCID: PMC9290528 DOI: 10.1093/rb/rbac043] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 05/28/2022] [Accepted: 06/10/2022] [Indexed: 02/05/2023] Open
Abstract
The secretome secreted by stem cells and bioactive material has emerged as a promising therapeutic choice for traumatic brain injury (TBI). We aimed to determine the effect of 3D-printed collagen/chitosan/secretome derived from human umbilical cord blood mesenchymal stem cells scaffolds (3D-CC-ST) on the injured tissue regeneration process. 3D-CC-ST was performed using 3D printing technology at a low temperature (−20°C), and the physical properties and degeneration rate were measured. The utilization of low temperature contributed to a higher cytocompatibility of fabricating porous 3D architectures that provide a homogeneous distribution of cells. Immediately after the establishment of the canine TBI model, 3D-CC-ST and 3D-CC (3D-printed collagen/chitosan scaffolds) were implanted into the cavity of TBI. Following implantation of scaffolds, neurological examination and motor evoked potential detection were performed to analyze locomotor function recovery. Histological and immunofluorescence staining were performed to evaluate neuro-regeneration. The group treated with 3D-CC-ST had good performance of behavior functions. Implanting 3D-CC-ST significantly reduced the cavity area, facilitated the regeneration of nerve fibers and vessel reconstruction, and promoted endogenous neuronal differentiation and synapse formation after TBI. The implantation of 3D-CC-ST also markedly reduced cell apoptosis and regulated the level of systemic inflammatory factors after TBI.
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Affiliation(s)
- Xiaoyin Liu
- West China Hospital, West China Medical School, Sichuan University Department of Neurosurgery, , Chengdu 610041, Sichuan, China
- Tianjin Key Laboratory of Neurotrauma Repair,Pingjin Hospital Brain Center , Characteristic Medical Center of People’s Armed Police Forces, Tianjin 300162, China
| | - Guijun Zhang
- West China Hospital, West China Medical School, Sichuan University Department of Neurosurgery, , Chengdu 610041, Sichuan, China
| | - Pan Wei
- The First People's Hospital Of Long Quan yi District Department of Neurosurgery, , Chengdu 610000, Sichuan, China
| | - Lin Zhong
- The First Affiliated Hospital of Chengdu Medical College , Chengdu 610500, Sichuan, China
| | - Yaxing Chen
- West China Hospital, West China Medical School, Sichuan University Department of Neurosurgery, , Chengdu 610041, Sichuan, China
| | - Jianyong Zhang
- the Affiliated Hospital of Guizhou Medical University Department of General Surgery, , Guiyang CN 540000, P. R., Guizhou, China
| | - Xuyi Chen
- Tianjin Key Laboratory of Neurotrauma Repair,Pingjin Hospital Brain Center , Characteristic Medical Center of People’s Armed Police Forces, Tianjin 300162, China
- Institute of Medical Security for Maritime Rights Protection of Characteristic Medical Center of Chinese People’s Armed Police Force (PAP) , Tianjin, 300162, China
| | - Liangxue Zhou
- West China Hospital, West China Medical School, Sichuan University Department of Neurosurgery, , Chengdu 610041, Sichuan, China
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Johnson NH, Hadad R, Taylor RR, Rodríguez Pilar J, Salazar O, Llompart-Pou JA, Dietrich WD, Keane RW, Pérez-Bárcena J, de Rivero Vaccari JP. Inflammatory Biomarkers of Traumatic Brain Injury. Pharmaceuticals (Basel) 2022; 15:ph15060660. [PMID: 35745576 PMCID: PMC9227014 DOI: 10.3390/ph15060660] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 05/20/2022] [Accepted: 05/23/2022] [Indexed: 12/26/2022] Open
Abstract
Traumatic brain injury (TBI) has a complex pathology in which the initial injury releases damage associated proteins that exacerbate the neuroinflammatory response during the chronic secondary injury period. One of the major pathological players in the inflammatory response after TBI is the inflammasome. Increased levels of inflammasome proteins during the acute phase after TBI are associated with worse functional outcomes. Previous studies reveal that the level of inflammasome proteins in biological fluids may be used as promising new biomarkers for the determination of TBI functional outcomes. In this study, we provide further evidence that inflammatory cytokines and inflammasome proteins in serum may be used to determine injury severity and predict pathological outcomes. In this study, we analyzed blood serum from TBI patients and respective controls utilizing Simple Plex inflammasome and V-PLEX inflammatory cytokine assays. We performed statistical analyses to determine which proteins were significantly elevated in TBI individuals. The receiver operating characteristics (ROC) were determined to obtain the area under the curve (AUC) to establish the potential fit as a biomarker. Potential biomarkers were then compared to documented patient Glasgow coma scale scores via a correlation matrix and a multivariate linear regression to determine how respective biomarkers are related to the injury severity and pathological outcome. Inflammasome proteins and inflammatory cytokines were elevated after TBI, and the apoptosis-associated speck like protein containing a caspase recruitment domain (ASC), interleukin (IL)-18, tumor necrosis factor (TNF)-α, IL-4 and IL-6 were the most reliable biomarkers. Additionally, levels of these proteins were correlated with known clinical indicators of pathological outcome, such as the Glasgow coma scale (GCS). Our results show that inflammatory cytokines and inflammasome proteins are promising biomarkers for determining pathological outcomes after TBI. Additionally, levels of biomarkers could potentially be utilized to determine a patient’s injury severity and subsequent pathological outcome. These findings show that inflammation-associated proteins in the blood are reliable biomarkers of injury severity that can also be used to assess the functional outcomes of TBI patients.
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Affiliation(s)
- Nathan H. Johnson
- Department of Physiology and Biophysics, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (N.H.J.); (R.H.); (R.W.K.)
| | - Roey Hadad
- Department of Physiology and Biophysics, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (N.H.J.); (R.H.); (R.W.K.)
| | - Ruby Rose Taylor
- Department of Neurological Surgery and The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (R.R.T.); (W.D.D.)
| | - Javier Rodríguez Pilar
- Intensive Care Department, Son Espases University Hospital, 07120 Palma de Mallorca, Spain; (J.R.P.); (O.S.); (J.A.L.-P.); (J.P.-B.)
| | - Osman Salazar
- Intensive Care Department, Son Espases University Hospital, 07120 Palma de Mallorca, Spain; (J.R.P.); (O.S.); (J.A.L.-P.); (J.P.-B.)
| | - Juan Antonio Llompart-Pou
- Intensive Care Department, Son Espases University Hospital, 07120 Palma de Mallorca, Spain; (J.R.P.); (O.S.); (J.A.L.-P.); (J.P.-B.)
| | - W. Dalton Dietrich
- Department of Neurological Surgery and The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (R.R.T.); (W.D.D.)
| | - Robert W. Keane
- Department of Physiology and Biophysics, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (N.H.J.); (R.H.); (R.W.K.)
- Department of Neurological Surgery and The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (R.R.T.); (W.D.D.)
| | - Jon Pérez-Bárcena
- Intensive Care Department, Son Espases University Hospital, 07120 Palma de Mallorca, Spain; (J.R.P.); (O.S.); (J.A.L.-P.); (J.P.-B.)
| | - Juan Pablo de Rivero Vaccari
- Department of Neurological Surgery and The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (R.R.T.); (W.D.D.)
- Correspondence:
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Wang Y, Wu Z, Wang D, Huang C, Xu J, Liu C, Yang C. Muscle-brain communication in pain: The key role of myokines. Brain Res Bull 2021; 179:25-35. [PMID: 34871710 DOI: 10.1016/j.brainresbull.2021.11.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 11/24/2021] [Accepted: 11/28/2021] [Indexed: 12/24/2022]
Abstract
Pain is the most common reason for a physician visit, which accounts for a considerable proportion of the global burden of disease and greatly affects patients' quality of life. Therefore, there is an urgent need to identify new therapeutic targets involved in pain. Exercise-induced hypoalgesia (EIH) is a well known phenomenon observed worldwide. However, the available evidence demonstrates that the mechanisms of EIH remain unclear. One of the most accepted hypotheses has been the activation of several endogenous systems in the brain. Recently, the concept that the muscle acts as a secretory organ has attracted increasing attention. Proteins secreted by the muscle are called myokines, playing a critical role in communicating with other organs, such as the brain. This review will focus on several myokines and discuss their roles in EIH.
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Affiliation(s)
- Yuanyuan Wang
- Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Zifeng Wu
- Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Di Wang
- Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Chaoli Huang
- Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China; State Key Laboratory of Pharmaceutical Biotechnology, Model Animal Research Center, Nanjing University, Nanjing 210061, China
| | - Jiali Xu
- Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Cunming Liu
- Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
| | - Chun Yang
- Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
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Carvalho TMD, Severo JS, Santos FGDSES, Cavalcante AKM, Havt A, Santos AAD, Torres-Leal FL, Tolentino M. Acute Strength Exercise Decreases Satiety by Modifying Blood Cytokines Levels in Physically Active Men. MOTRIZ: REVISTA DE EDUCACAO FISICA 2020. [DOI: 10.1590/s1980-65742020000400176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | - Moisés Tolentino
- Universidade Federal do Piauí, Brazil; Universidade Federal do Piauí, Brazil; Universidade Federal do Piauí, Brazil
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Wan G, Wang L, Zhang G, Zhang J, Lu Y, Li J, Yi X. Effects of probiotics combined with early enteral nutrition on endothelin-1 and C-reactive protein levels and prognosis in patients with severe traumatic brain injury. J Int Med Res 2019; 48:300060519888112. [PMID: 31802692 PMCID: PMC7604984 DOI: 10.1177/0300060519888112] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To investigate the effects of probiotics combined with early enteral nutrition on levels of endothelin-1 (ET-1), C-reactive protein (CRP), and inflammatory factors, and on the prognosis of patients with severe traumatic brain injury (TBI). METHODS We enrolled 76 adults with severe TBI. The patients were divided randomly into two equal groups administered enteral nutrition with and without probiotics, respectively. Demographic and clinical data including age, sex, Glasgow Coma Scale score, Sequential Organ Failure Score, Acute Physiology, Chronic Health Score, hospitalization, mortality, and infections were recorded. RESULTS Serum levels of inflammatory factors gradually decreased with increasing treatment time in both groups. However, ET-1 at 15 days, and interleukin (IL)-6, IL-10, tumor necrosis factor (TNF)-α, and CRP at 7 and 15 days decreased significantly more in the combined treatment group. Hospitalization duration and pulmonary infection rates were also significantly reduced in the combined compared with the enteral nutrition alone group. GCS scores at 15 days were significantly lower in the combined compared with the enteral nutrition group. CONCLUSION Probiotics combined with early enteral nutrition could reduce serum levels of ET-1, CRP, and IL-6, IL-10, and TNF-α, and could thus improve the recovery of patients with severe TBI.
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Affiliation(s)
- Guohua Wan
- Department of Nutrition, Shengli Oilfield Central Hospital, Dongying, China
| | - Linlin Wang
- Department of Nutrition, Shengli Oilfield Central Hospital, Dongying, China
| | - Guanhong Zhang
- Joint Surgery, Shengli Oilfield Central Hospital, Dongying, China
| | - Jian Zhang
- Hepatobiliary Surgery, Shengli Oilfield Central Hospital, Dongying, China
| | - Yanli Lu
- Department of Nutrition, Shengli Oilfield Central Hospital, Dongying, China
| | - Jun Li
- Department of Surgery, Sinopec Group Shengli Petroleum Administration Shengcai Hospital, Dongying, China
| | - Xinhao Yi
- Scientific Education Section, Shengli Oilfield Central Hospital, Dongying, China
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Wu W, Guan Y, Zhao G, Fu XJ, Guo TZ, Liu YT, Ren XL, Wang W, Liu HR, Li YQ. Elevated IL-6 and TNF-α Levels in Cerebrospinal Fluid of Subarachnoid Hemorrhage Patients. Mol Neurobiol 2015; 53:3277-3285. [PMID: 26063595 DOI: 10.1007/s12035-015-9268-1] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 05/28/2015] [Indexed: 11/26/2022]
Abstract
The present study investigated the correlation between interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) levels in cerebrospinal fluid (CSF) and subarachnoid hemorrhage (SAH) progression. A meta-analysis was further conducted from pooled data to analyze the clinical value of IL-6 and TNF-α in SAH diagnosis. In our case-control study, a total of 57 SAH patients were assigned to two groups, CVS group (n = 27) and non-CVS group (n = 30), based on the presence of cerebral vasospasm (CVS). In addition, 65 healthy subjects were enrolled as controls. IL-6 and TNF-α levels in CSF were measured in all the study subjects by enzyme-linked immunosorbent assay (ELISA). For meta-analysis, an exhaustive literature search was conducted to identify relevant published articles and strict inclusion and exclusion criteria were applied to select studies for the present meta-analysis. Data extracted from these studies was analyzed using STATA 12.0 software. IL-6 and TNF-α levels in CSF of SAH patients were markedly higher than those of healthy controls (all P < 0.001). Further, CVS patients showed elevated IL-6 and TNF-α levels in CSF compared to non-CVS patients (all P < 0.001). The increase in IL-6 and TNF-α levels in CSF correlated with the increasing disease severity, based on Hunt-Hess grade, in SAH patients (all P < 0.05). Our meta-analysis also confirmed that IL-6 and TNF-α CSF levels were markedly higher in SAH patients compared to healthy controls (all P < 0.001). Ethnicity-stratified analysis showed that both IL-6 and TNF-α CSF levels were elevated in Asian SAH patients, compared to their healthy counterparts (all P < 0.05). The TNF-α CSF levels were significantly higher in Caucasian SAH patients (P < 0.001), but the IL-6 CSF levels showed no such differences compared to the healthy controls (P = 0.219). Subgroup analysis based on the presence of CVS showed that both IL-6 and TNF-α CSF levels were markedly higher in CVS patients than those in non-CVS patients (all P < 0.05). Our results provide strong evidence that IL-6 and TNF-α CSF levels are elevated in SAH patients and may participate in SAH development. Thus, these two cytokines could be important biomarkers for early diagnosis and disease monitoring in SAH patients.
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Affiliation(s)
- Wei Wu
- Department of Neurosurgery, The First Hospital of Jilin University, No 71 Xinmin Street, Changchun, 130021, Jilin Province, China
| | - Yi Guan
- Department of Neurosurgery, The First Hospital of Jilin University, No 71 Xinmin Street, Changchun, 130021, Jilin Province, China
| | - Gang Zhao
- Department of Neurosurgery, The First Hospital of Jilin University, No 71 Xinmin Street, Changchun, 130021, Jilin Province, China
| | - Xi-Jia Fu
- Department of Neurology, The First Hospital of Jilin University, Changchun, 130021, Jilin Province, China
| | - Tie-Zhu Guo
- Department of Neurosurgery, The First Hospital of Jilin University, No 71 Xinmin Street, Changchun, 130021, Jilin Province, China
| | - Yue-Ting Liu
- Department of Neurosurgery, The First Hospital of Jilin University, No 71 Xinmin Street, Changchun, 130021, Jilin Province, China
| | - Xin-Liang Ren
- Department of Neurosurgery, The First Hospital of Jilin University, No 71 Xinmin Street, Changchun, 130021, Jilin Province, China
| | - Wei Wang
- Department of Neurosurgery, The First Hospital of Jilin University, No 71 Xinmin Street, Changchun, 130021, Jilin Province, China
| | - Han-Rui Liu
- Department of Neurosurgery, The First Hospital of Jilin University, No 71 Xinmin Street, Changchun, 130021, Jilin Province, China
| | - Yun-Qian Li
- Department of Neurosurgery, The First Hospital of Jilin University, No 71 Xinmin Street, Changchun, 130021, Jilin Province, China.
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