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Abraira L, López-Maza S, Quintana M, Fonseca E, Toledo M, Campos-Fernández D, Lallana S, Grau-López L, Ciurans J, Jiménez M, Becerra JL, Bustamante A, Rubiera M, Penalba A, Montaner J, Álvarez Sabin J, Santamarina E. Exploratory study of blood biomarkers in patients with post-stroke epilepsy. Eur Stroke J 2024:23969873241244584. [PMID: 38557165 DOI: 10.1177/23969873241244584] [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: 04/04/2024] Open
Abstract
INTRODUCTION In addition to clinical factors, blood-based biomarkers can provide useful information on the risk of developing post-stroke epilepsy (PSE). Our aim was to identify serum biomarkers at stroke onset that could contribute to predicting patients at higher risk of PSE. PATIENTS AND METHODS From a previous study in which 895 acute stroke patients were followed-up, 51 patients developed PSE. We selected 15 patients with PSE and 15 controls without epilepsy. In a biomarker discovery setting, 5 Olink panels of 96 proteins each, were used to determine protein levels. Biomarkers that were down-regulated and overexpressed in PSE patients, and those that showed the strongest interactions with other proteins were validated using an enzyme-linked immunosorbent assay in samples from 50 PSE patients and 50 controls. A ROC curve analysis was used to evaluate the predictive ability of significant biomarkers to develop PSE. RESULTS Mean age of the PSE discovery cohort was 68.56 ± 15.1, 40% women and baseline NIHSS 12 [IQR 1-25]. Nine proteins were down-expressed: CASP-8, TNFSF-14, STAMBP, ENRAGE, EDA2R, SIRT2, TGF-alpha, OSM and CLEC1B. VEGFa, CD40 and CCL4 showed greatest interactions with the remaining proteins. In the validation analysis, TNFSF-14 was the single biomarker showing statistically significant downregulated levels in PSE patients (p = 0.006) and it showed a good predictive capability to develop PSE (AUC 0.733, 95% CI 0.601-0.865). DISCUSSION AND CONCLUSION Protein expression in PSE patients differs from that of non-epileptic stroke patients, suggesting the involvement of several different proteins in post-stroke epileptogenesis. TNFSF-14 emerges as a potential biomarker for predicting PSE.
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Affiliation(s)
- Laura Abraira
- Epilepsy Unit, Neurology Department, Vall d'Hebron University Hospital, Vall d'Hebron Barcelona Hospital Campus. Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain
- Research Group on Status Epilepticus and Acute Seizures, Vall d'Hebron Research Institute (VHIR), Vall d'Hebron University Hospital, Vall d'Hebron Hospital Campus, Barcelona, Spain
| | - Samuel López-Maza
- Epilepsy Unit, Neurology Department, Vall d'Hebron University Hospital, Vall d'Hebron Barcelona Hospital Campus. Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain
- Research Group on Status Epilepticus and Acute Seizures, Vall d'Hebron Research Institute (VHIR), Vall d'Hebron University Hospital, Vall d'Hebron Hospital Campus, Barcelona, Spain
| | - Manuel Quintana
- Epilepsy Unit, Neurology Department, Vall d'Hebron University Hospital, Vall d'Hebron Barcelona Hospital Campus. Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain
- Research Group on Status Epilepticus and Acute Seizures, Vall d'Hebron Research Institute (VHIR), Vall d'Hebron University Hospital, Vall d'Hebron Hospital Campus, Barcelona, Spain
| | - Elena Fonseca
- Epilepsy Unit, Neurology Department, Vall d'Hebron University Hospital, Vall d'Hebron Barcelona Hospital Campus. Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain
- Research Group on Status Epilepticus and Acute Seizures, Vall d'Hebron Research Institute (VHIR), Vall d'Hebron University Hospital, Vall d'Hebron Hospital Campus, Barcelona, Spain
| | - Manuel Toledo
- Epilepsy Unit, Neurology Department, Vall d'Hebron University Hospital, Vall d'Hebron Barcelona Hospital Campus. Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain
- Research Group on Status Epilepticus and Acute Seizures, Vall d'Hebron Research Institute (VHIR), Vall d'Hebron University Hospital, Vall d'Hebron Hospital Campus, Barcelona, Spain
| | - Daniel Campos-Fernández
- Epilepsy Unit, Neurology Department, Vall d'Hebron University Hospital, Vall d'Hebron Barcelona Hospital Campus. Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain
- Research Group on Status Epilepticus and Acute Seizures, Vall d'Hebron Research Institute (VHIR), Vall d'Hebron University Hospital, Vall d'Hebron Hospital Campus, Barcelona, Spain
| | - Sofía Lallana
- Epilepsy Unit, Neurology Department, Vall d'Hebron University Hospital, Vall d'Hebron Barcelona Hospital Campus. Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain
- Research Group on Status Epilepticus and Acute Seizures, Vall d'Hebron Research Institute (VHIR), Vall d'Hebron University Hospital, Vall d'Hebron Hospital Campus, Barcelona, Spain
| | - Laia Grau-López
- Epilepsy Unit, Neurology Department, Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - Jordi Ciurans
- Epilepsy Unit, Neurology Department, Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - Marta Jiménez
- Epilepsy Unit, Neurology Department, Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - Juan Luis Becerra
- Epilepsy Unit, Neurology Department, Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - Alejandro Bustamante
- Stroke Unit, Neurology Department, Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - Marta Rubiera
- Stroke Unit, Neurology Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Anna Penalba
- Neurovascular Research Laboratory, Vall d'Hebron Institute of Research (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joan Montaner
- Neurovascular Research Laboratory, Vall d'Hebron Institute of Research (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - José Álvarez Sabin
- Neurology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Estevo Santamarina
- Epilepsy Unit, Neurology Department, Vall d'Hebron University Hospital, Vall d'Hebron Barcelona Hospital Campus. Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain
- Research Group on Status Epilepticus and Acute Seizures, Vall d'Hebron Research Institute (VHIR), Vall d'Hebron University Hospital, Vall d'Hebron Hospital Campus, Barcelona, Spain
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Wu Y, Zhao Z, Kang S, Zhang L, Lv F. Potential application of peripheral blood biomarkers in intracranial aneurysms. Front Neurol 2023; 14:1273341. [PMID: 37928138 PMCID: PMC10620808 DOI: 10.3389/fneur.2023.1273341] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 10/05/2023] [Indexed: 11/07/2023] Open
Abstract
Intracranial aneurysm (IA) counts are increasing yearly, with a high mortality and disability after rupture. Current diagnosis and treatment rely on costly equipment, lacking effective indicators for progression prediction and specific drugs for treatment. Recently, peripheral blood biomarkers, as common clinical test samples, reflecting the immune and inflammatory state of the body in real-time, have shown promise in providing additional information for risk stratification and treatment in IA patients, which may improve their outcomes after aneurysm rupture through anti-inflammatory therapy. Therefore, this paper reviewed the progress of potential biomarkers of IAs, including inflammatory blood indicators, cytokines, and blood lipids, aiming to aid individual management and therapy of aneurysms in clinical practices.
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Affiliation(s)
- Yangying Wu
- Department of Radiology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Ziya Zhao
- Department of Radiology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Shaolei Kang
- Department of Radiology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
- The Department of Medical Imaging, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Lijuan Zhang
- Department of Radiology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Fajin Lv
- Department of Radiology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
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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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Schranz D, Molnar T, Erdo-Bonyar S, Simon D, Berki T, Zavori L, Szolics A, Buki A, Lenzser G, Csecsei P. Fatty Acid-Binding Protein 3 and CXC-Chemokine Ligand 16 are Associated with Unfavorable Outcome in Aneurysmal Subarachnoid Hemorrhage. J Stroke Cerebrovasc Dis 2021; 30:106068. [PMID: 34455150 DOI: 10.1016/j.jstrokecerebrovasdis.2021.106068] [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: 05/27/2021] [Revised: 08/11/2021] [Accepted: 08/14/2021] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Aneurysmal subarachnoid hemorrhage (aSAH) is associated with activation of the inflammatory cascade contributing to unfavorable outcome and secondary complications, such as delayed cerebral ischemia (DCI). Both fatty acid-binding protein 3 (FABP3) and CXC-chemokine ligand 16 (CXCL-16) have been linked to vascular inflammation and cellular death. The authors aimed to assess the 30-day prognostic value of serum levels of FABP3 and CXCL-16 and explore their associations with DCI in aSAH patients. METHODS A total of 60 patients with aSAH were prospectively enrolled. Sampling for markers was done at 24 hours after the index event. FABP3 and CXCL-16 serum concentrations were determined by MilliPlex multiplex immunoassay method. The primary endpoint was unfavorable outcome at Day 30 based on the modified Rankin Scale. RESULTS Both FABP3 and CXCL-16 levels were significantly elevated in patients with unfavorable outcome compared to those with favorable outcome after aSAH (FABP3: 2133 pg/mL, IQR: 1053-4567 vs. 3773, 3295-13116; p<0.003 and CXCL-16: 384 pg/mL, 313-502 vs. 498, 456-62, p<0.001). The area under the curve (AUC) for serum CXCL-16 levels as a predictor of unfavorable outcome at Day 30 was 0.747 (95% CI =0.622-0.871; p<0.001). Based on binary logistic regression analysis, serum CXCL-16 with a cut-off level >446.7 ng/L independently predicted Day 30 unfavorable outcome with a sensitivity of 81% and a specificity of 62%. Neither CXCL-16 nor FABP3 showed a significant correlation with DCI. CONCLUSION Early FABP3 and CXCL-16 levels are significantly associated with poor 30-day outcome in patients with aSAH.
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Affiliation(s)
- Daniel Schranz
- Department of Neurology, University of Pecs, Medical School, Pecs, Hungary
| | - Tihamer Molnar
- Department of Anaesthesiology and Intensive Care, University of Pecs, Medical School, Pecs, Hungary.
| | - Szabina Erdo-Bonyar
- Department of Immunology and Biotechnology, University of Pecs, Medical School, Pecs, Hungary
| | - Diana Simon
- Department of Immunology and Biotechnology, University of Pecs, Medical School, Pecs, Hungary
| | - Tímea Berki
- Department of Immunology and Biotechnology, University of Pecs, Medical School, Pecs, Hungary
| | - Laszlo Zavori
- Salisbury NHS Foundation Trust, Salisbury, United Kingdom
| | - Alex Szolics
- Department of Radiology, University of Örebro, Örebro, Sweeden
| | - Andras Buki
- Department of Neurosurgery, University of Pecs, Medical School, Pecs, Hungary
| | - Gabor Lenzser
- Department of Neurosurgery, University of Pecs, Medical School, Pecs, Hungary
| | - Peter Csecsei
- Department of Neurosurgery, University of Pecs, Medical School, Pecs, Hungary
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