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Hervella P, Sampedro-Viana A, Fernández-Rodicio S, Rodríguez-Yáñez M, López-Dequidt I, Pumar JM, Mosqueira AJ, Bazarra-Barreiros M, Abengoza-Bello MT, Ortega-Espina S, Ouro A, Pérez-Mato M, Campos F, Sobrino T, Castillo J, Alonso-Alonso ML, Iglesias-Rey R. Precision Medicine for Blood Glutamate Grabbing in Ischemic Stroke. Int J Mol Sci 2024; 25:6554. [PMID: 38928260 PMCID: PMC11204254 DOI: 10.3390/ijms25126554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 06/01/2024] [Accepted: 06/09/2024] [Indexed: 06/28/2024] Open
Abstract
Glutamate grabbers, such as glutamate oxaloacetate transaminase (GOT), have been proposed to prevent excitotoxicity secondary to high glutamate levels in stroke patients. However, the efficacy of blood glutamate grabbing by GOT could be dependent on the extent and severity of the disruption of the blood-brain barrier (BBB). Our purpose was to analyze the relationship between GOT and glutamate concentration with the patient's functional status differentially according to BBB serum markers (soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) and leukoaraiosis based on neuroimaging). This retrospective observational study includes 906 ischemic stroke patients. We studied the presence of leukoaraiosis and the serum levels of glutamate, GOT, and sTWEAK in blood samples. Functional outcome was assessed using the modified Rankin Scale (mRS) at 3 months. A significant negative correlation between GOT and glutamate levels at admission was shown in those patients with sTWEAK levels > 2900 pg/mL (Pearson's correlation coefficient: -0.249; p < 0.0001). This correlation was also observed in patients with and without leukoaraiosis (Pearson's correlation coefficients: -0.299; p < 0.001 vs. -0.116; p = 0.024). The logistic regression model confirmed the association of higher levels of GOT with lower odds of poor outcome at 3 months when sTWEAK levels were >2900 pg/mL (OR: 0.41; CI 95%: 0.28-0.68; p < 0.0001) or with leukoaraiosis (OR: 0.75; CI 95%: 0.69-0.82; p < 0.0001). GOT levels are associated with glutamate levels and functional outcomes at 3 months, but only in those patients with leukoaraiosis and elevated sTWEAK levels. Consequently, therapies targeting glutamate grabbing might be more effective in patients with BBB dysfunction.
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Grants
- SAF2017-84267-R, PDC2021-121455-I00 Spanish Ministry of Science and Innovation
- IN607A2022-03, IN607A2022/07 Xunta de Galicia
- PI17/01103, PI22/00938, PI21/01256/, DTS23/00103, RD16/0019/0001, RD21/0006/0003, CB22/05/00067, CPII17/00027, CPII19/00020, CP22/00061, FI22/00200 Instituto de Salud Carlos III
- EAPA_791/2018_ NEUROATLANTIC, 0624_2IQBIONEURO_6_E INTERREG
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Affiliation(s)
- Pablo Hervella
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (P.H.); (A.S.-V.); (S.F.-R.); (J.M.P.); (A.J.M.); (M.B.-B.); (M.T.A.-B.); (S.O.-E.); (J.C.)
| | - Ana Sampedro-Viana
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (P.H.); (A.S.-V.); (S.F.-R.); (J.M.P.); (A.J.M.); (M.B.-B.); (M.T.A.-B.); (S.O.-E.); (J.C.)
| | - Sabela Fernández-Rodicio
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (P.H.); (A.S.-V.); (S.F.-R.); (J.M.P.); (A.J.M.); (M.B.-B.); (M.T.A.-B.); (S.O.-E.); (J.C.)
| | - Manuel Rodríguez-Yáñez
- Stroke Unit, Department of Neurology, Hospital Clínico Universitario, 15706 Santiago de Compostela, Spain;
| | - Iria López-Dequidt
- Department of Neurology, Hospital Clínico Universitario de Ferrol, 15405 Ferrol, Spain;
| | - José M. Pumar
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (P.H.); (A.S.-V.); (S.F.-R.); (J.M.P.); (A.J.M.); (M.B.-B.); (M.T.A.-B.); (S.O.-E.); (J.C.)
- Department of Neuroradiology, Hospital Clínico Universitario, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Antonio J. Mosqueira
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (P.H.); (A.S.-V.); (S.F.-R.); (J.M.P.); (A.J.M.); (M.B.-B.); (M.T.A.-B.); (S.O.-E.); (J.C.)
- Department of Neuroradiology, Hospital Clínico Universitario, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Marcos Bazarra-Barreiros
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (P.H.); (A.S.-V.); (S.F.-R.); (J.M.P.); (A.J.M.); (M.B.-B.); (M.T.A.-B.); (S.O.-E.); (J.C.)
| | - María Teresa Abengoza-Bello
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (P.H.); (A.S.-V.); (S.F.-R.); (J.M.P.); (A.J.M.); (M.B.-B.); (M.T.A.-B.); (S.O.-E.); (J.C.)
| | - Sara Ortega-Espina
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (P.H.); (A.S.-V.); (S.F.-R.); (J.M.P.); (A.J.M.); (M.B.-B.); (M.T.A.-B.); (S.O.-E.); (J.C.)
| | - Alberto Ouro
- NeuroAging Group (NEURAL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (A.O.); (T.S.)
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - María Pérez-Mato
- Translational Stroke Laboratory (TREAT), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (M.P.-M.); (F.C.)
| | - Francisco Campos
- Translational Stroke Laboratory (TREAT), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (M.P.-M.); (F.C.)
| | - Tomás Sobrino
- NeuroAging Group (NEURAL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (A.O.); (T.S.)
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - José Castillo
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (P.H.); (A.S.-V.); (S.F.-R.); (J.M.P.); (A.J.M.); (M.B.-B.); (M.T.A.-B.); (S.O.-E.); (J.C.)
| | - Maria Luz Alonso-Alonso
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (P.H.); (A.S.-V.); (S.F.-R.); (J.M.P.); (A.J.M.); (M.B.-B.); (M.T.A.-B.); (S.O.-E.); (J.C.)
| | - Ramón Iglesias-Rey
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain; (P.H.); (A.S.-V.); (S.F.-R.); (J.M.P.); (A.J.M.); (M.B.-B.); (M.T.A.-B.); (S.O.-E.); (J.C.)
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2
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Hervella P, Sampedro-Viana A, Rodríguez-Yáñez M, López-Dequidt I, Pumar JM, Mosqueira AJ, Fernández-Rodicio S, Bazarra-Barreiros M, Serena J, Silva-Blas Y, Gubern-Merida C, Rey-Aldana D, Cinza S, Campos F, Sobrino T, Castillo J, Alonso-Alonso ML, Iglesias-Rey R. Systemic biomarker associated with poor outcome after futile reperfusion. Eur J Clin Invest 2024; 54:e14181. [PMID: 38361320 DOI: 10.1111/eci.14181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 02/06/2024] [Accepted: 02/06/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Successful recanalization does not lead to complete tissue reperfusion in a considerable percentage of ischemic stroke patients. This study aimed to identify biomarkers associated with futile recanalization. Leukoaraiosis predicts poor outcomes of this phenomenon. Soluble tumour necrosis factor-like weak inducer of apoptosis (sTWEAK), which is associated with leukoaraiosis degrees, could be a potential biomarker. METHODS This study includes two cohorts of ischemic stroke patients in a multicentre retrospective observational study. Effective reperfusion, defined as a reduction of ≥8 points in the National Institutes of Health Stroke Scale (NIHSS) within the first 24 h, was used as a clinical marker of effective reperfusion. RESULTS In the first cohort study, female sex, age, and high NIHSS at admission (44.7% vs. 81.1%, 71.3 ± 13.7 vs. 81.1 ± 6.7; 16 [13, 21] vs. 23 [17, 28] respectively; p < .0001) were confirmed as predictors of futile recanalization. ROC curve analysis showed that leukocyte levels (sensitivity of 99%, specificity of 55%) and sTWEAK level (sensitivity of 92%, specificity of 88%) can discriminate between poor and good outcomes. Both biomarkers simultaneously are higher associated with outcome after effective reperfusion (OR: 2.17; CI 95% 1.63-4.19; p < .0001) than individually (leukocytes OR: 1.38; CI 95% 1.00-1.64, p = .042; sTWEAK OR: 1.00; C I95% 1.00-1.01, p = .019). These results were validated using a second cohort, where leukocytes and sTWEAK showed a sensitivity of 100% and specificity of 66.7% and 75% respectively. CONCLUSIONS Leukocyte and sTWEAK could be biomarkers of reperfusion failure and subsequent poor outcomes. Further studies will be necessary to explore its role in reperfusion processes.
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Affiliation(s)
- Pablo Hervella
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain
| | - Ana Sampedro-Viana
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain
| | | | - Iria López-Dequidt
- Stroke Unit, Department of Neurology, Hospital Clínico Universitario, A Coruña, Spain
| | - José M Pumar
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain
- Department of Neuroradiology, Hospital Clínico Universitario, Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain
| | - Antonio J Mosqueira
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain
- Department of Neuroradiology, Hospital Clínico Universitario, Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain
| | - Sabela Fernández-Rodicio
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain
| | - Marcos Bazarra-Barreiros
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain
| | - Joaquín Serena
- Cerebrovascular Pathology Research Group, Stroke Unit, Department of Neurology, Hospital Universitari Dr. Josep Trueta de Girona, Girona Biomedical Research Institute (IDIBGI), Girona, Spain
| | - Yolanda Silva-Blas
- Cerebrovascular Pathology Research Group, Stroke Unit, Department of Neurology, Hospital Universitari Dr. Josep Trueta de Girona, Girona Biomedical Research Institute (IDIBGI), Girona, Spain
| | - Carme Gubern-Merida
- Cerebrovascular Pathology Research Group, Girona Biomedical Research Institute (IDIBGI), Parc Hospitalari Martí I Julià, Salt, Spain
| | - Daniel Rey-Aldana
- Centro de Salud de A Estrada, Area Sanitaria de Santiago de Compostela, A Estrada, Spain
| | - Sergio Cinza
- Centro de Saúde O Milladoiro, Santiago de Compostela, Spain
| | - Francisco Campos
- Translational Stroke Laboratory (TREAT), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain
| | - Tomás Sobrino
- NeuroAging Laboratory Group (NEURAL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain
| | - José Castillo
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain
| | - Maria Luz Alonso-Alonso
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain
| | - Ramón Iglesias-Rey
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain
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3
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Batista S, Bocanegra-Becerra JE, Claassen B, Rubião F, Rabelo NN, Figueiredo EG, Oberman DZ. Biomarkers in aneurysmal subarachnoid hemorrhage: A short review. World Neurosurg X 2023; 19:100205. [PMID: 37206060 PMCID: PMC10189293 DOI: 10.1016/j.wnsx.2023.100205] [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: 11/01/2022] [Revised: 04/17/2023] [Accepted: 04/19/2023] [Indexed: 05/21/2023] Open
Abstract
Poor outcomes of aneurysmal subarachnoid hemorrhage (aSAH) can be the result of the initial catastrophic event or the many acute or delayed neurological complications. Recent evidence suggests that some molecules play a critical role in both events, through some unknown pathways involved. Understanding the role of these molecules in these events could allow to improve diagnostic accuracy, guide management, and prevent long-term disability in aSAH. Here we present the studies on aSAH biomarkers present in current medical literature, highlighting their roles and main results.
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Affiliation(s)
- Sávio Batista
- Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Bernardo Claassen
- Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Felipe Rubião
- Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | - Dan Zimelewicz Oberman
- Department of Neurosurgery, Hospital de Força Aérea do Galeão, Rio de Janeiro, Brazil
- Corresponding author. Neurosurgery Department Hospital Força Aérea do Galeão, Estrada do Galeão, 4101 - Galeão, Rio de Janeiro - RJ, 21941-353, Brazil.
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4
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Silva‐Candal A, Custodia A, López‐Dequidt I, Rodríguez‐Yáñez M, Alonso‐Alonso ML, Ávila‐Gómez P, Pumar JM, Castillo J, Sobrino T, Campos F, Iglesias‐Rey R, Hervella P. sTWEAK
is a leukoaraiosis biomarker associated with neurovascular angiopathy. Ann Clin Transl Neurol 2022; 9:171-180. [PMID: 35060359 PMCID: PMC8862435 DOI: 10.1002/acn3.51502] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/15/2021] [Accepted: 12/27/2021] [Indexed: 12/14/2022] Open
Abstract
Objective Leukoaraiosis (LA) refers to white matter lesions of undetermined etiology associated with the appearance and worsening of vascular pathologies. The aim is to confirm an increased frequency and intensity of LA in symptomatic patients with neurovascular pathology compared with asymptomatic subjects, and its association with circulating serum levels of soluble tumor necrosis factor‐like weak inducer of apoptosis (sTWEAK). Methods An observational study was conducted in which two groups of patients were compared. Group I (N = 242) comprised of asymptomatic subjects with arterial hypertension and/or diabetes or with a history of transient ischemic attacks, and Group II (N = 382) comprised patients with lacunar stroke or deep hemispheric intracerebral hemorrhage (ICH) of hypertensive origin. Serum levels of sTWEAK were analyzed and correlated with prevalence and intensity of LA according to the Fazekas scale. Results The prevalence of LA was higher in symptomatic (85.1%) versus asymptomatic patients (62.0%). Logistic regression model showed a significant relation of LA with neurovascular pathologies (OR: 2.69, IC 95%: 1.10–6.59, p = 0.003). When stratified according to the Fazekas scale, LA of grade II (OR: 3.53, IC 95%: 1.10–6.59, p = 0.003) and specially grade III (OR: 4.66, 95% CI: 1.09–19.84, p = 0.037) showed correlation with neurovascular pathologies. Increased sTWEAK levels were found in the symptomatic group in all LA grades (p < 0.0001), and associated with 5.06 times more risk of presenting clinical symptoms (OR: 5.06, 95% CI: 2.66–9.75, p < 0.0001). Interpretation LA showed a higher prevalence in patients with symptomatic lacunar stroke or deep hemispheric ICH. There is an association between sTWEAK levels and LA degree.
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Affiliation(s)
- Andrés Silva‐Candal
- Clinical Neurosciences Research Laboratories (LINC) Health Research Institute of Santiago de Compostela (IDIS) Santiago de Compostela Spain
- Neurovascular Diseases Laboratory Neurology Service University Hospital Complex of A Coruña Biomedical Research Institute (INIBIC) A Coruña Spain
| | - Antia Custodia
- Clinical Neurosciences Research Laboratories (LINC) Health Research Institute of Santiago de Compostela (IDIS) Santiago de Compostela Spain
| | - Iria López‐Dequidt
- Stroke Unit Department of Neurology Hospital Clínico Universitario Santiago de Compostela Spain
| | - Manuel Rodríguez‐Yáñez
- Stroke Unit Department of Neurology Hospital Clínico Universitario Santiago de Compostela Spain
| | - Maria Luz Alonso‐Alonso
- Clinical Neurosciences Research Laboratories (LINC) Health Research Institute of Santiago de Compostela (IDIS) Santiago de Compostela Spain
| | - Paulo Ávila‐Gómez
- Clinical Neurosciences Research Laboratories (LINC) Health Research Institute of Santiago de Compostela (IDIS) Santiago de Compostela Spain
| | - José M. Pumar
- Department of Neuroradiology Hospital Clínico Universitario Health Research Institute of Santiago de Compostela (IDIS) Santiago de Compostela Spain
| | - José Castillo
- Clinical Neurosciences Research Laboratories (LINC) Health Research Institute of Santiago de Compostela (IDIS) Santiago de Compostela Spain
| | - Tomás Sobrino
- Clinical Neurosciences Research Laboratories (LINC) Health Research Institute of Santiago de Compostela (IDIS) Santiago de Compostela Spain
| | - Francisco Campos
- Clinical Neurosciences Research Laboratories (LINC) Health Research Institute of Santiago de Compostela (IDIS) Santiago de Compostela Spain
| | - Ramón Iglesias‐Rey
- Clinical Neurosciences Research Laboratories (LINC) Health Research Institute of Santiago de Compostela (IDIS) Santiago de Compostela Spain
| | - Pablo Hervella
- Clinical Neurosciences Research Laboratories (LINC) Health Research Institute of Santiago de Compostela (IDIS) Santiago de Compostela Spain
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5
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Yao H, Lv C, Luo F, He C. Plasma cellular prion protein concentrations correlate with severity and prognosis of aneurysmal subarachnoid hemorrhage. Clin Chim Acta 2021; 523:114-119. [PMID: 34537219 DOI: 10.1016/j.cca.2021.09.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/13/2021] [Accepted: 09/13/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cellular prion protein (PrPc) is greatly expressed in injured brain tissues. We investigates correlation of plasma PrPc concentrations with severity, delayed cerebral ischemia (DCI) plus prognosis following aneurysmal subarachnoid hemorrhage (aSAH). METHODS Plasma PrPc concentrations were measured in 110 aSAH patients and 110 healthy controls. The World Federation of Neurological Surgeons scale (WFNS) score, Glasgow coma scale (GCS) score, Hunt-Hess score and modified Fisher score were utilized to assess hemorrhagic severity. Relations of plasma PrPc concentrations to DCI and 90-day poor outcome (Glasgow outcome scale score of 1-3) were analyzed using multivariate analysis. Prognostic predictive capabilities were determined under receiver operating characteristic curve. RESULTS Plasma PrPc concentrations were significantly higher in patients than in controls. Plasma PrPc concentrations were tightly correlated with WFNS score, GCS score, Hunt-Hess score and modified Fisher score. Plasma PrPc emerged as an independent predictor for 90-day poor outcome, but not for DCI. Plasma PrPc concentrations exhibited similar prognostic predictive abilities, as compared to WFNS score, GCS score, Hunt-Hess score and modified Fisher score. CONCLUSIONS Plasma PrPc concentrations are highly associated with severity and poor outcome after hemorrhagic stroke, indicating that plasma PrPc may serve as a useful prognostic biomarker for aSAH.
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Affiliation(s)
- Hongfeng Yao
- Medical Laboratory, Zhuji Affiliated Hospital of Wenzhou Medical University, 9 Jianmin Road, Zhuji 311800, China
| | - Caiping Lv
- Medical Laboratory, Zhuji Affiliated Hospital of Wenzhou Medical University, 9 Jianmin Road, Zhuji 311800, China
| | - Fangjun Luo
- Medical Laboratory, Zhuji Affiliated Hospital of Wenzhou Medical University, 9 Jianmin Road, Zhuji 311800, China.
| | - Chao He
- Department of Neurosurgery, Zhuji Affiliated Hospital of Wenzhou Medical University, 9 Jianmin Road, Zhuji 311800, China
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Schranz D, Molnar T, Erdo‐Bonyar S, Simon D, Berki T, Nagy C, Czeiter E, Buki A, Lenzser G, Csecsei P. Increased level of LIGHT/TNFSF14 is associated with survival in aneurysmal subarachnoid hemorrhage. Acta Neurol Scand 2021; 143:530-537. [PMID: 33492677 DOI: 10.1111/ane.13394] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/18/2020] [Accepted: 12/28/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Multiple cytokines have been implicated in aneurysmal subarachnoid hemorrhage (aSAH), but tumor necrosis factor superfamily 14 (LIGHT/TNFSF14) and oncostatin-M (OSM) have not been previously explored. AIMS OF THE STUDY The primary objective of this study was to examine the relationship between TNFSF14 and OSM levels and survival. Our secondary goal was to investigate a potential association between these markers and the incidence of delayed cerebral ischemia (DCI). MATERIALS & METHODS We consecutively recruited 60 patients with a clinical diagnosis of aSAH. LIGHT/TNFSF14 and OSM serum concentrations were determined by ELISA. The primary endpoint was survival at Day 30, while development of DCI was assessed as secondary outcome. RESULTS Patients had significantly higher levels of both markers than the control group (median of LIGHT: 18.1 pg/ml vs. 7 pg/ml; p = 0.01; median of OSM: 10.3 pg/ml vs. 2.8 pg/ml, p < 0.001). Significantly lower serum level of LIGHT/TNFSF14 was found in nonsurviving patients (n = 9) compared with survivors (n = 51; p = 0.011). Based on ROC analysis, serum LIGHT/TNFSF14 with a cutoff value of >7.95 pg/ml predicted 30-day survival with a sensitivity of 71% and specificity of 78% (Area: 0.763; 95% CI: 0.604-0.921, p = 0.013). In addition, it was also a predictor of DCI with a sensitivity of 72.7% and a specificity of 62.5% (AUC: 0.702; 95% CI: 0.555-0.849, p = 0.018). Based on binary logistic regression analysis, LIGHT/TNFSF14 was found to be independently associated with 30-day mortality, but not with DCI. CONCLUSION In this cohort, a higher serum level of LIGHT/TNFSF14 was associated with increased survival of patients with aSAH.
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Affiliation(s)
- Daniel Schranz
- Department of Neurology University of PecsMedical School Pecs Hungary
| | - Tihamer Molnar
- Department of Anaesthesiology and Intensive Care University of PecsMedical School Pecs Hungary
| | - Szabina Erdo‐Bonyar
- Department of Immunology and Biotechnology University of PecsMedical School Pecs Hungary
| | - Diana Simon
- Department of Immunology and Biotechnology University of PecsMedical School Pecs Hungary
| | - Tímea Berki
- Department of Immunology and Biotechnology University of PecsMedical School Pecs Hungary
| | - Csaba Nagy
- Department of Neurosurgery University of PecsMedical School Pecs Hungary
| | - Endre Czeiter
- Department of Neurosurgery University of PecsMedical School Pecs Hungary
- Neurotrauma Research Group Szentágothai Research Centre University of Pécs Pécs Hungary
- MTA‐PTE Clinical Neuroscience MR Research Group Pécs Hungary
| | - Andras Buki
- Department of Neurosurgery University of PecsMedical School Pecs Hungary
| | - Gabor Lenzser
- Department of Neurosurgery University of PecsMedical School Pecs Hungary
| | - Peter Csecsei
- Department of Neurosurgery University of PecsMedical School Pecs Hungary
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7
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da Silva-Candal A, López-Dequidt I, Rodriguez-Yañez M, Ávila-Gómez P, Pumar JM, Castillo J, Sobrino T, Campos F, Iglesias-Rey R, Hervella P. sTWEAK is a marker of early haematoma growth and leukoaraiosis in intracerebral haemorrhage. Stroke Vasc Neurol 2021; 6:528-535. [PMID: 33758070 PMCID: PMC8717766 DOI: 10.1136/svn-2020-000684] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/24/2020] [Accepted: 01/16/2021] [Indexed: 11/17/2022] Open
Abstract
Objective To study the association between early growth of haematoma with biomarkers of endothelial dysfunction such as leukoaraiosis (LA) and the soluble tumour necrosis factor-like weak inducer of apoptosis (sTWEAK) in patients with intracerebral haemorrhage (ICH). Methods This is a retrospective observational study of patients with nontraumatic ICH. Clinical and biochemical parameters were analysed. sTWEAK levels were measured by ELISA. LA was analysed in the hemisphere without haemorrhage to avoid interference with the acute injury. The main endpoint was the haematoma growth evaluated by the difference in volume between the second and the initial neuroimage. Poor functional outcome, defined as a modified Rankin Scale >2 at 3 months, was considered as secondary endpoint. Receiver operating characteristic curve analysis was performed to stablish the best cut-off for sTWEAK levels associated with haematoma growth. Results We included 653 patients with ICH in our analysis (71.1±11.9 years, 44% women). Haematoma growth was observed in 188 patients (28.8%). sTWEAK levels ≥5600 pg/mL predicted ICH growth with a sensitivity of 84% and a specificity of 87%. sTWEAK levels ≥5600 pg/mL and the presence of LA were associated with haematoma growth (OR: 42.46; (CI 95% 22.67 to 79.52) and OR: 2.73 (CI 95% 1.39 to 5.34), respectively). Also, the presence of LA (OR: 4.31 (CI 95% 2.89 to 6.42)) and the interaction between ICH growth and sTWEAK (OR: 2.23 (CI 95% 1.40 to 3.55)) were associated with poor functional outcome at 3 months. Conclusion sTWEAKs, together with the presence and grade of LA, are biomarkers able to predict ICH growth and poor functional outcome in patients with ICH.
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Affiliation(s)
- Andrés da Silva-Candal
- Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Iria López-Dequidt
- Department of Neurology, Hospital Clínico Universitario, Santiago de Compostela, Spain
| | | | - Paulo Ávila-Gómez
- Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - José Manuel Pumar
- Department of Neuroradiology, Hospital Clínico Universitario, Santiago de Compostela, Spain
| | - José Castillo
- Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Tomás Sobrino
- Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Francisco Campos
- Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Ramón Iglesias-Rey
- Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Pablo Hervella
- Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
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