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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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Vlachogiannis P, Hillered L, Enblad P, Ronne-Engström E. Temporal patterns of inflammation-related proteins measured in the cerebrospinal fluid of patients with aneurysmal subarachnoid hemorrhage using multiplex Proximity Extension Assay technology. PLoS One 2022; 17:e0263460. [PMID: 35324941 PMCID: PMC8947082 DOI: 10.1371/journal.pone.0263460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 01/19/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The complexity of the inflammatory response post subarachnoid hemorrhage (SAH) may require temporal analysis of multiple protein biomarkers simultaneously to be more accurately described. METHODS Ventricular cerebrospinal fluid was collected at days 1, 4 and 10 after SAH in 29 patients. Levels of 92 inflammation-related proteins were simultaneously measured using Target 96 Inflammation ® assay (Olink Proteomics, Uppsala, Sweden) based on Proximity Extension Assay (PEA) technology. Twenty-eight proteins were excluded from further analysis due to lack of >50% of measurable values. Temporal patterns of the remaining 64 proteins were analyzed. Repeated measures ANOVA and its nonparametric equivalent Friedman's ANOVA were used for comparisons of means between time points. RESULTS Four different patterns (Groups A-D) were visually observed with an early peak and gradually decreasing trend (11 proteins), a middle peak (10 proteins), a late peak after a gradually increasing trend (30 proteins) and no specific pattern (13 proteins). Statistically significant early peaks defined as Day 1 > Day 4 values were noticed in 4 proteins; no significant decreasing trends defined as Day 1 > Day 4 > Day 10 values were observed. Two proteins showed significant middle peaks (i.e. Day 1 < Day 4 > Day 10 values). Statistically significant late peaks (i.e. Day 4 < Day 10 values) and increasing trends (i.e. Day 1 < Day 4 < Day 10 values) were observed in 14 and 10 proteins, respectively. Four of Group D proteins showed biphasic peaks and the rest showed stable levels during the observation period. CONCLUSION The comprehensive data set provided in this explorative study may act as an illustration of an inflammatory profile of the acute phase of SAH showing groups of potential protein biomarkers with similar temporal patterns of activation, thus facilitating further research on their role in the pathophysiology of the disease.
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Affiliation(s)
- Pavlos Vlachogiannis
- Department of Neurosciences, Neurosurgery, Uppsala University, Uppsala, Sweden
- * E-mail:
| | - Lars Hillered
- Department of Neurosciences, Neurosurgery, Uppsala University, Uppsala, Sweden
| | - Per Enblad
- Department of Neurosciences, Neurosurgery, Uppsala University, Uppsala, Sweden
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Jun Q, Luo W. Early-stage serum Stanniocalcin 1 as a predictor of outcome in patients with aneurysmal subarachnoid hemorrhage. Medicine (Baltimore) 2021; 100:e28222. [PMID: 34941085 PMCID: PMC8701780 DOI: 10.1097/md.0000000000028222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 11/24/2021] [Indexed: 01/05/2023] Open
Abstract
Stanniocalcin-1 (STC1) takes part in anti-inflammatory and anti-oxidative processes, thus demonstrating neuroprotective properties. Early brain injuries associated with initial subarachnoid hemorrhage typically led to secondary cerebral infarction and poor outcomes. This retrospective study aimed to clarify the clinical significance of serum STC1 level in patients with subarachnoid hemorrhage.We collected demographic information, comorbidities, neurological status in detail. All blood samples were collected on admission. Enzyme-linked immunosorbent assay kits were used to detect the serum level of STC1. Spearman analysis was used to explore the relationship between STC1 and clinical severity. Multivariate logistic regression was used to investigate the prognostic role of STC1 in patients with aneurysmal subarachnoid hemorrhage (aSAH). Receiver operating characteristic curve was performed to investigate the power of STC1 in predicting outcome in aSAH patients.Serum STC1 concentration was significantly higher in aSAH patients than in healthy individuals. Serum concentration of STC1 positively correlated with Hunt-Hess grade (r = 0.62, P < .01) and Fisher grade (r = 0.48, P < .01), and negatively correlated with Glasgow Coma Scale on admission (r = -0.45, P < .01). Patients with delayed cerebral ischemia (DCI) had higher level of serum STC1 than those without DCI (13.12 ± 1.44 vs 8.56 ± 0.31, P < .01). Moreover, patients with poor outcome had higher concentration of STC1 than patients with good outcome (11.82 ± 0.62 vs 8.21 ± 0.35,P < 0.01). Results of univariate and multivariate logistic analysis revealed that Hunt-hess III-IV, DCI, and high STC1 level were independent risk factors associated with poor outcome of patients with aSAH. Further analysis revealed that combination of STC1 with Hunt-hess grade was more superior to 2 indicators alone in predicting clinical outcome of aSAH patients.STC1 can be used as a novel biomarker in predicting outcome of patients with aSAH, especially when combined with Hunt-hess grade.
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Affiliation(s)
- Qin Jun
- Department of Neurosurgery, the Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Liuzhou City, Guangxi, China
| | - Weijian Luo
- Department of Neurosurgery, Shenzhen People's Hospital, Second Clinical Medical College of Ji’nan University, Shenzhen, China
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Banoei MM, Casault C, Metwaly SM, Winston BW. Metabolomics and Biomarker Discovery in Traumatic Brain Injury. J Neurotrauma 2019; 35:1831-1848. [PMID: 29587568 DOI: 10.1089/neu.2017.5326] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Traumatic brain injury (TBI) is one of the leading causes of disability and mortality worldwide. The TBI pathogenesis can induce broad pathophysiological consequences and clinical outcomes attributed to the complexity of the brain. Thus, the diagnosis and prognosis are important issues for the management of mild, moderate, and severe forms of TBI. Metabolomics of readily accessible biofluids is a promising tool for establishing more useful and reliable biomarkers of TBI than using clinical findings alone. Metabolites are an integral part of all biochemical and pathophysiological pathways. Metabolomic processes respond to the internal and external stimuli resulting in an alteration of metabolite concentrations. Current high-throughput and highly sensitive analytical tools are capable of detecting and quantifying small concentrations of metabolites, allowing one to measure metabolite alterations after a pathological event when compared to a normal state or a different pathological process. Further, these metabolic biomarkers could be used for the assessment of injury severity, discovery of mechanisms of injury, and defining structural damage in the brain in TBI. Metabolic biomarkers can also be used for the prediction of outcome, monitoring treatment response, in the assessment of or prognosis of post-injury recovery, and potentially in the use of neuroplasticity procedures. Metabolomics can also enhance our understanding of the pathophysiological mechanisms of TBI, both in primary and secondary injury. Thus, this review presents the promising application of metabolomics for the assessment of TBI as a stand-alone platform or in association with proteomics in the clinical setting.
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Affiliation(s)
| | - Colin Casault
- 1 Department of Critical Care Medicine, University of Calgary , Alberta, Canada
| | | | - Brent W Winston
- 2 Departments of Critical Care Medicine, Medicine and Biochemistry and Molecular Biology, University of Calgary , Calgary, Alberta, Canada
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Casault C, Al Sultan AS, Banoei M, Couillard P, Kramer A, Winston BW. Cytokine Responses in Severe Traumatic Brain Injury: Where There Is Smoke, Is There Fire? Neurocrit Care 2019; 30:22-32. [PMID: 29569129 DOI: 10.1007/s12028-018-0522-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This scoping review will discuss the basic functions and prognostic significance of the commonly researched cytokines implicated in severe traumatic brain injury (sTBI), including tumour necrosis factor-α (TNF-α), interleukin-1β (IL-1β), IL-6, tissue inhibitor of matrix metalloproteinases-1 (TIMP-1), transforming growth factor-β (TGF-β), substance P, and soluble CD40 ligand (sCD40L). A scoping review was undertaken with an electronic search for articles from the Ovid MEDLINE, PUBMED and EMBASE databases from 1995 to 2017. Inclusion criteria were original research articles, and reviews including both animal models and human clinical studies of acute (< 3 months) sTBI. Selected articles included both isolated sTBI and sTBI with systemic injury. After applying the inclusion criteria and removing duplicates, 141 full-text articles, 126 original research articles and 15 review articles, were evaluated in compiling this review paper. A single reviewer, CC, completed the review in two phases. During the first phase, titles and abstracts of selected articles were reviewed for inclusion. A second evaluation was then conducted on the full text of all selected articles to ensure relevancy. From our current understanding of the literature, it is unlikely a single biomarker will be sufficient in accurately prognosticating patients with sTBI. Intuitively, a more severe injury will demonstrate higher levels of inflammatory cytokines which may correlate as a marker of severe injury. This does not mean, necessarily, these cytokines have a direct and causal role in the poor outcome of the patient. Further research is required to better delineate the complex systemic inflammatory and CNS interactions that occur during sTBI before they can be applied as a reliable prognostic tool.
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Affiliation(s)
- Colin Casault
- Department of Critical Care Medicine, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada. .,Department of Clinical Neurosciences and Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.
| | - Abdulaziz S Al Sultan
- Department of Clinical Neurosciences and Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Mohammad Banoei
- Department of Critical Care Medicine, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Philippe Couillard
- Department of Critical Care Medicine, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada.,Department of Clinical Neurosciences and Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Andreas Kramer
- Department of Critical Care Medicine, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada.,Department of Clinical Neurosciences and Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Brent W Winston
- Department of Critical Care Medicine, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada.,Departments of Medicine and Biochemistry and Molecular Biology, University of Calgary, Calgary, AB, Canada
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Cai H, Zheng S, Cai B, Yao P, Ding C, Chen F, Kang D. Neuroglobin as a Novel Biomarker for Predicting Poor Outcomes in Aneurysmal Subarachnoid Hemorrhage. World Neurosurg 2018; 116:e258-e265. [PMID: 29738858 DOI: 10.1016/j.wneu.2018.04.184] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 04/23/2018] [Accepted: 04/24/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Neuroglobin (Ngb) has a high affinity for oxygen and helps prevent hypoxic-ischemic brain damage. In this study we analyzed the relationship between Ngb levels and clinical outcomes of aneurysmal subarachnoid hemorrhage (aSAH). METHODS Serum Ngb levels were measured in 58 patients with aSAH and 27 control individuals using the enzyme-linked immunosorbent assay. To continuously assess aSAH, we measured serum Ngb levels on days 1, 2, 3, 5, and 7 after aSAH. Clinical data were collected using the Hunt and Hess Scale, the Glasgow Coma Scale (GCS), the World Federation of Neurological Surgeons (WFNS) Scale, and the modified Fisher Scale. Clinical outcomes included 6-month mortality and 6-month unfavorable outcomes (modified Rankin Scale (mRS) score of 3-6). RESULTS Serum Ngb levels increased after aSAH, peaked on day 2, and then gradually decreased. Serum Ngb levels on admission were higher in the patient group than in the control group (7.67 ± 2.56 ng/mL vs. 6.45 ± 0.88 ng/mL, P < 0.05). Multivariate logistic regression analysis indicated that serum Ngb levels on day 2 after aSAH were independently related to 6-month mortality (odds ratio [OR] = 0.265, 95% confidence interval [CI] = 0.094-0.747, P < 0.05) and 6-month unfavorable outcomes (OR = 1.919, 95% CI = 1.158-3.180, P < 0.05), and receiver operating characteristic curve analysis showed that serum Ngb levels on day 2 predicted 6-month mortality and 6-month unfavorable outcomes, with areas under the curve of 0.893 (P < 0.05; 95% CI, 0.812-0.974) and 0.818 (P < 0.05; 95% CI, 0.691-0.954), respectively, based on the best thresholds. CONCLUSIONS Serum Ngb levels on day 2 after aSAH were strongly associated with poor outcomes in aSAH, suggesting that Ngb may be a novel biomarker for predicting poor outcomes in aSAH.
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Affiliation(s)
- Hanpei Cai
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Shufa Zheng
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Bin Cai
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Peisen Yao
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Chenyu Ding
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Fuxiang Chen
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Dezhi Kang
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
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Savarraj JPJ, Parsha K, Hergenroeder GW, Zhu L, Bajgur SS, Ahn S, Lee K, Chang T, Kim DH, Liu Y, Choi HA. Systematic model of peripheral inflammation after subarachnoid hemorrhage. Neurology 2017; 88:1535-1545. [PMID: 28314864 DOI: 10.1212/wnl.0000000000003842] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 11/16/2016] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To investigate inflammatory processes after aneurysmal subarachnoid hemorrhage (aSAH) with network models. METHODS This is a retrospective observational study of serum samples from 45 participants with aSAH analyzed at multiple predetermined time points: <24 hours, 24 to 48 hours, 3 to 5 days, and 6 to 8 days after aSAH. Concentrations of cytokines were measured with a 41-plex human immunoassay kit, and the Pearson correlation coefficients between all possible cytokine pairs were computed. Systematic network models were constructed on the basis of correlations between cytokine pairs for all participants and across injury severity. Trends of individual cytokines and correlations between them were examined simultaneously. RESULTS Network models revealed that systematic inflammatory activity peaks at 24 to 48 hours after the bleed. Individual cytokine levels changed significantly over time, exhibiting increasing, decreasing, and peaking trends. Platelet-derived growth factor (PDGF)-AA, PDGF-AB/BB, soluble CD40 ligand, and tumor necrosis factor-α (TNF-α) increased over time. Colony-stimulating factor (CSF) 3, interleukin (IL)-13, and FMS-like tyrosine kinase 3 ligand decreased over time. IL-6, IL-5, and IL-15 peaked and decreased. Some cytokines with insignificant trends show high correlations with other cytokines and vice versa. Many correlated cytokine clusters, including a platelet-derived factor cluster and an endothelial growth factor cluster, were observed at all times. Participants with higher clinical severity at admission had elevated levels of several proinflammatory and anti-inflammatory cytokines, including IL-6, CCL2, CCL11, CSF3, IL-8, IL-10, CX3CL1, and TNF-α, compared to those with lower clinical severity. CONCLUSIONS Combining reductionist and systematic techniques may lead to a better understanding of the underlying complexities of the inflammatory reaction after aSAH.
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Affiliation(s)
| | - Kaushik Parsha
- From the University of Texas Health Science Center at Houston
| | | | - Liang Zhu
- From the University of Texas Health Science Center at Houston
| | - Suhas S Bajgur
- From the University of Texas Health Science Center at Houston
| | - Sungho Ahn
- From the University of Texas Health Science Center at Houston
| | - Kiwon Lee
- From the University of Texas Health Science Center at Houston
| | - Tiffany Chang
- From the University of Texas Health Science Center at Houston
| | - Dong H Kim
- From the University of Texas Health Science Center at Houston
| | - Yin Liu
- From the University of Texas Health Science Center at Houston
| | - H Alex Choi
- From the University of Texas Health Science Center at Houston.
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Huang YL, Han ZJ, Hu ZD. Red blood cell distribution width and neutrophil to lymphocyte ratio are associated with outcomes of adult subarachnoid haemorrhage patients admitted to intensive care unit. Ann Clin Biochem 2017; 54:696-701. [PMID: 27932670 DOI: 10.1177/0004563216686623] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background Red blood cell distribution width (RDW) and neutrophil to lymphocyte ratio (NLR) have been reported to be associated with outcomes of acute cerebral infarction. However, their prognostic value in patients with subarachnoid haemorrhage (SAH) remains largely unknown. The aim of this study was to investigate the prognostic value of RDW and NLR in SAH patients. Methods Medical records of adult SAH patients admitted to intensive care unit (ICU) were extracted from Multiparameter Intelligent Monitoring in Intensive Care II (MIMIC II, version 2.6), a publicly accessible ICU database. Prognostic value of RDW and NLR was analysed using logistic regression model, Kaplan-Meier curve analysis and Cox regression model. Results A total of 274 SAH patients were included. Patients died in hospital had significantly higher RDW and NLR. RDW and NLR were significantly associated with hospital death, with adjusted odds ratios of 1.39 (95% CI, 1.06–1.82) and 1.04 (95% CI, 1.00–1.08), respectively. Furthermore, increased RDW and NLR were associated with higher one-year mortality, with an adjusted hazard ratio of 1.20 (95% CI, 1.02–1.41) for per 1% increased RDW and 1.03 (95% CI, 1.00–1.05) for per 1 increased NLR. Conclusion RDW and NLR are useful indices to evaluate the outcomes of ICU admitted patients with SAH.
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Affiliation(s)
- Yuan-Lan Huang
- Department of Laboratory Medicine, Chinese People’s Liberation Army No. 455 Hospital, Shanghai, PR China
| | - Zhi-Jun Han
- Department of Laboratory Medicine, Wuxi Second People’s Hospital of Nanjing Medical University, Jiangsu, PR China
| | - Zhi-De Hu
- Department of Laboratory Medicine, the General Hospital of Ji'nan Military Command Region, Ji'nan, PR China
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Wang J, Wang JF, Hu XM. Caspase-3 in serum predicts outcome after aneurysmal subarachnoid hemorrhage. Clin Chim Acta 2016; 460:196-202. [DOI: 10.1016/j.cca.2016.07.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 06/30/2016] [Accepted: 07/01/2016] [Indexed: 01/31/2023]
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Ding YS, Sun B, Jiang JX, Zhang Q, Lu J, Gao GZ. Increased serum concentrations of signal peptide-Cub-Egf domain-containing protein-1 in patients with aneurysmal subarachnoid hemorrhage. Clin Chim Acta 2016; 459:117-122. [DOI: 10.1016/j.cca.2016.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 04/26/2016] [Accepted: 06/02/2016] [Indexed: 02/07/2023]
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Elevation of serum CXC chemokine ligand-12 levels predicts poor outcome after aneurysmal subarachnoid hemorrhage. J Neurol Sci 2016; 362:53-8. [DOI: 10.1016/j.jns.2016.01.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 01/10/2016] [Accepted: 01/14/2016] [Indexed: 11/23/2022]
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Dai JX, Cai JY, Lin Q, Chen XD, Lu C, Sun J, Ba HJ. Thioredoxin as a marker for severity and prognosis of aneurysmal subarachnoid hemorrhage. J Neurol Sci 2016; 363:84-9. [PMID: 27000227 DOI: 10.1016/j.jns.2016.02.043] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 02/06/2016] [Accepted: 02/16/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Circulating levels of thioredoxin (Trx), a potent anti-oxidant that modulates inflammation, cell growth and apoptosis, are increased in various critical care conditions. The purpose of this study was to establish the relationship between serum Trx levels and prognosis of aneurysmal subarachnoid hemorrhage (aSAH). METHODS An enzyme-linked immunosorbent assay measurement of Trx was performed in serum from 132 patients and 132 healthy volunteers. Clinical outcomes included 6-month mortality and unfavorable outcome (Glasgow outcome scale score of 1-3). RESULTS The serum Trx levels were significantly higher in patients than in controls (23.4±12.2 ng/mL vs.8.5±4.0 ng/mL, P<0.001) and had close relation to the World Federation of Neurological Surgeons (WFNS) scores (r=0.461, P<0.001) and modified Fisher scores (r=0.459, P<0.001). Trx was an independent predictor for 6-month mortality (Odds ratio, 1.386; 95% confidence interval, 1.015-2.161; P<0.001) and 6-month unfavorable outcome (Odds ratio, 1.297; 95% confidence interval, 1.012-2.002; P<0.001). Based on receiver operating characteristic curve, TRX had similar prognostic value compared with WFNS scores and modified Fisher scores and also significantly improved their prognostic value for 6-month unfavorable outcome, but not for 6-month mortality. CONCLUSIONS Elevated plasma Trx levels are correlated with the severity and poor prognosis, substantializing Trx as a potential prognostic predictive biomarker following aSAH.
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Affiliation(s)
- Jun-Xia Dai
- Department of Neurosurgery, The Central Hospital of Wenzhou City, 32 Dajian Lane, Wenzhou 325000, China
| | - Jian-Yong Cai
- Department of Neurosurgery, The Central Hospital of Wenzhou City, 32 Dajian Lane, Wenzhou 325000, China
| | - Qun Lin
- Department of Neurosurgery, The Central Hospital of Wenzhou City, 32 Dajian Lane, Wenzhou 325000, China
| | - Xian-Dong Chen
- Department of Neurosurgery, The Central Hospital of Wenzhou City, 32 Dajian Lane, Wenzhou 325000, China
| | - Chuan Lu
- Department of Neurosurgery, The Central Hospital of Wenzhou City, 32 Dajian Lane, Wenzhou 325000, China
| | - Jun Sun
- Department of Neurosurgery, The Central Hospital of Wenzhou City, 32 Dajian Lane, Wenzhou 325000, China
| | - Hua-Jun Ba
- Department of Neurosurgery, The Central Hospital of Wenzhou City, 32 Dajian Lane, Wenzhou 325000, China.
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