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Kiang JG, Woods AK, Cannon G. Effects of Hemorrhage on Hematopoietic Cell Depletion after a Combined Injury with Radiation: Role of White Blood Cells and Red Blood Cells as Biomarkers. Int J Mol Sci 2024; 25:2988. [PMID: 38474235 DOI: 10.3390/ijms25052988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 02/27/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024] Open
Abstract
Combined radiation with hemorrhage (combined injury, CI) exacerbates hematopoietic acute radiation syndrome and mortality compared to radiation alone (RI). We evaluated the effects of RI or CI on blood cell depletion as a biomarker to differentiate the two. Male CD2F1 mice were exposed to 8.75 Gy γ-radiation (60Co). Within 2 h of RI, animals were bled under anesthesia 0% (RI) or 20% (CI) of total blood volume. Blood samples were collected at 4-5 h and days 1, 2, 3, 7, and 15 after RI. CI decreased WBC at 4-5 h and continued to decrease it until day 3; counts then stayed at the nadir up to day 15. CI decreased neutrophils, lymphocytes, monocytes, eosinophils, and basophils more than RI on day 1 or day 2. CI decreased RBCs, hemoglobin, and hematocrit on days 7 and 15 more than RI, whereas hemorrhage alone returned to the baseline on days 7 and 15. RBCs depleted after CI faster than post-RI. Hemorrhage alone increased platelet counts on days 2, 3, and 7, which returned to the baseline on day 15. Our data suggest that WBC depletion may be a potential biomarker within 2 days post-RI and post-CI and RBC depletion after 3 days post-RI and post-CI. For hemorrhage alone, neutrophil counts at 4-5 h and platelets for day 2 through day 7 can be used as a tool for confirmation.
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Affiliation(s)
- Juliann G Kiang
- Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, 4555 South Palmer Road, Building 42, Bethesda, MD 20889-5648, USA
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
- Department of Pharmacology and Molecular Therapeutics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Akeylah K Woods
- Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, 4555 South Palmer Road, Building 42, Bethesda, MD 20889-5648, USA
| | - Georgetta Cannon
- Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, 4555 South Palmer Road, Building 42, Bethesda, MD 20889-5648, USA
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Rendevski V, Aleksovski B, Mihajlovska Rendevska A, Hadzi-Petrushev N, Manusheva N, Shuntov B, Gjorgoski I. Inflammatory and oxidative stress markers in intracerebral hemorrhage: Relevance as prognostic markers for quantification of the edema volume. Brain Pathol 2022; 33:e13106. [PMID: 35762501 PMCID: PMC10041164 DOI: 10.1111/bpa.13106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 06/08/2022] [Indexed: 01/24/2023] Open
Abstract
We aimed to analyze the inflammatory and oxidative stress (OS) markers after intracerebral hemorrhage (ICH) and their temporal changes, interaction effects, and prognostic values as biomarkers for the prediction of the edema volume. Our prospective, longitudinal study included a cohort group of 73 conservatively treated patients with ICH, without hematoma expansion or intraventricular bleeding, which were initialized with the same treatment and provided with the same in-hospital care during the disease course. Study procedures included multilevel comprehensive analyses of clinical and neuroimaging data, aligned with the exploration of 19 inflammatory and five OS markers. White blood cells (WBC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), neutrophilia, and lymphopenia peaked 3 days post-ICH, and they showed much stronger correlations with clinical and neuroimaging variables, when compared to the admission values. An intricate interplay among inflammatory (WBC, CRP, neutrophils, neutrophil-to-lymphocyte ratio [NLR], interleukin (IL)-6, and IL-10) and OS mechanisms (catalase activity and advanced oxidation protein products [AOPP]) was detected operating 3-days post-ICH, being assessed as relevant for prediction of the edema. The overall results suggested complex pathology of formation of post-ICH edema, via: (A) Not additive, but statistically significant synergistic interactions between CRP-ESR, neutrophils-CRP, and neutrophils-IL-6 as drivers for the edema formation; (B) Significant antagonistic effect of high protein oxidation on the CRP-edema dependence, suggesting a mechanism of potential OS-CRP negative feedback loop and redox inactivation of CRP. The final multiple regression model separated the third-day variables NLR, CRP × AOPP, and WBC, as significant prognostic biomarkers for the prediction of the edema volume, with NLR being associated with the highest effect size. Our developed mathematical equation with 3D modeling for prediction and quantification of the edema volume might be beneficial for taking timely adequate strategies for prevention of delayed neurological deteriorations.
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Affiliation(s)
- Vladimir Rendevski
- Medical Faculty, Ss. Cyril and Methodius University in Skopje, Skopje, North Macedonia
| | - Boris Aleksovski
- Faculty of Natural Sciences and Mathematics-Skopje, Institute of Biology, Ss. Cyril and Methodius University in Skopje, Skopje, North Macedonia
| | | | - Nikola Hadzi-Petrushev
- Faculty of Natural Sciences and Mathematics-Skopje, Institute of Biology, Ss. Cyril and Methodius University in Skopje, Skopje, North Macedonia
| | - Nensi Manusheva
- Medical Faculty, Ss. Cyril and Methodius University in Skopje, Skopje, North Macedonia
| | - Blagoj Shuntov
- Medical Faculty, Ss. Cyril and Methodius University in Skopje, Skopje, North Macedonia
| | - Icko Gjorgoski
- Faculty of Natural Sciences and Mathematics-Skopje, Institute of Biology, Ss. Cyril and Methodius University in Skopje, Skopje, North Macedonia
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Xu Y, Ma HY, Qiao CY, Peng Y, Ding Q, Xiang RL, Wang LZ, Yan JF, Hou Y, Di F. Significance of changes in the concentration of inflammatory factors in blood or cerebrospinal fluid in evaluating the severity and prognosis of spontaneous cerebral hemorrhage: A systematic review and meta-analysis. Clin Neurol Neurosurg 2021; 205:106631. [PMID: 33887504 DOI: 10.1016/j.clineuro.2021.106631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/22/2021] [Accepted: 03/28/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Spontaneous intracerebral hemorrhage (SICH) often leads to severe disability, while inflammation plays an important role in SICH-induced secondary brain injury. The purpose of this study was to investigate the value of inflammatory factors as a means of evaluating the prognosis of SICH and to investigate the relationship between inflammatory factors and the severity and prognosis of SICH. METHODS The articles published before November 1 2020 were searched through PubMed, EMBASE, Cochrane library and web of science. Revman5.3 was used, using the inverse variance model to pool the SMD of TNF-a and interleukin concentration. RESULTS A total of 25 studies involving 3333 subjects were included in this paper. The concentration of TNF-α in the blood or cerebrospinal fluid of severe SICH patients was significantly higher than that of milder SICH patients or healthy population; SICH patients with high TNF-α concentration had a 1.06 times greater odds of poor outcomes than patients with low TNF-α concentration, odds ratio (OR) = 1.06[95% CI, 1.01-1.12]. The concentration of interleukin-6 (IL-6) in severe SICH patients was significantly higher than that in milder SICH patients; patients with high IL-6 concentration had a 2.61 times greater odds of poor outcomes than patients with low IL-6 concentration, OR = 2.61[95% CI, 1.79-3.80]. CONCLUSIONS The detection of concentrations of TNF-α and IL-6 in peripheral blood may be helpful for the objective and quantitative assessment of the severity and prognosis of patients with SICH, and have certain significance for the selection of appropriate treatment options.
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Affiliation(s)
- Yan Xu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100160, China
| | - Hai-Yang Ma
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100160, China
| | - Chun-You Qiao
- Department of Endocrinology, Zhangjiakou First Hospital, Zhangjiakou, Hebei 075041, China
| | - Yi Peng
- Department of Endocrinology, Zhangjiakou First Hospital, Zhangjiakou, Hebei 075041, China
| | - Qi Ding
- Department of Neurosurgery, Zhangjiakou First Hospital, Zhangjiakou, Hebei 075041, China
| | - Ruo-Lan Xiang
- Department of Physiology and Pathophysiology, Peking University School of Basic Medical Sciences, Beijing 100191, China
| | - Li-Zhong Wang
- Department of Neurosurgery, Zhangjiakou First Hospital, Zhangjiakou, Hebei 075041, China
| | - Jun-Fei Yan
- Department of Neurosurgery, Zhangjiakou First Hospital, Zhangjiakou, Hebei 075041, China
| | - Yuan Hou
- Department of Neurosurgery, Zhangjiakou First Hospital, Zhangjiakou, Hebei 075041, China
| | - Fei Di
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100160, China; Department of Neurosurgery, Zhangjiakou First Hospital, Zhangjiakou, Hebei 075041, China.
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Jiang W, Jin P, Bao Q, Wei W, Jiang W. Prognostic significance of serum translocator protein in patients with spontaneous intracerebral hematoma:preliminary findings. Neurol Res 2020; 43:412-417. [PMID: 33357157 DOI: 10.1080/01616412.2020.1866372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: The aim of this study was to measure the level of translocator protein (TSPO) in patients with intracerebral hematoma (ICH) and to determine whether TSPO can predict ICH outcomes.Method: Patients with ICH were recruited at Wujin Hospital Affiliated with Jiangsu University between January 2018 and May 2020. The level of TSPO and inflammatory factors were analyzed by enzyme-linked immunosorbent assay (ELISA). A receiver operating characteristic curve (ROC) analysis was applied to assess the accuracy of TSPO for predicting patient outcomes.Result: The median of TSPO was 2.26 ng/ml. The lower- (46 cases) and higher-(51 cases) TSPO groups were thus divided based on the median value. The perihematomal edema (PHE) volume in the lower TSPO group was 6.3 ± 1.3 ml which was significantly lower than that in higher-TSPO group (14.8 ± 3.5 ml) (p < 0.05). The serum level of the interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP) in the higher-TSPO group was significantly higher than that in the lower TSPO group (p < 0.05). The Spearman's correlation found that TSPO concentrations significantly correlated with PHE volume, modified Rankin Scale score (MRS), IL-1β, IL-6, TNF-α, and CRP concentrations. The area under the ROC (AUC), specificity, sensitivity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and Diagnostic Odds Ratio (DOR) of TSPO was 0.932, 82.1%, 89.9%, 5.02, 0.12, and 40.8, respectively, which was more reliable than other inflammatory factors.Conclusion: The TSPO may a reliable biomarker in predicting the prognosis of ICH patients.
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Affiliation(s)
- Wenqing Jiang
- Department of Neurosurgery, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, China.,Department of Neurosurgery, The Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China
| | - Peng Jin
- Department of Neurosurgery, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, China.,Department of Neurosurgery, The Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China
| | - Qing Bao
- Department of Neurosurgery, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, China.,Department of Neurosurgery, The Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China
| | - Wenfeng Wei
- Department of Neurosurgery, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, China.,Department of Neurosurgery, The Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China
| | - Wei Jiang
- Department of Neurosurgery, Wujin Hospital Affiliated with Jiangsu University, Changzhou, Jiangsu, China.,Department of Neurosurgery, The Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China
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Modeling prognostic factors for poor neurological outcome in conservatively treated patients with intracerebral hemorrhage: A focus on TNF-α. Clin Neurol Neurosurg 2018; 172:51-58. [DOI: 10.1016/j.clineuro.2018.06.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 06/15/2018] [Accepted: 06/26/2018] [Indexed: 12/21/2022]
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