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Bobeff EJ, Bukowiecka-Matusiak M, Stawiski K, Wiśniewski K, Burzynska-Pedziwiatr I, Kordzińska M, Kowalski K, Sendys P, Piotrowski M, Szczesna D, Stefańczyk L, Wozniak LA, Jaskólski DJ. Plasma Amino Acids May Improve Prediction Accuracy of Cerebral Vasospasm after Aneurysmal Subarachnoid Haemorrhage. J Clin Med 2022; 11:jcm11020380. [PMID: 35054073 PMCID: PMC8779950 DOI: 10.3390/jcm11020380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/25/2021] [Accepted: 01/05/2022] [Indexed: 11/16/2022] Open
Abstract
Aneurysmal subarachnoid haemorrhages (aSAH) account for 5% of strokes and continues to place a great burden on patients and their families. Cerebral vasospasm (CVS) is one of the main causes of death after aSAH, and is usually diagnosed between day 3 and 14 after bleeding. Its pathogenesis remains poorly understood. To verify whether plasma concentration of amino acids have prognostic value in predicting CVS, we analysed data from 35 patients after aSAH (median age 55 years, IQR 39-62; 20 females, 57.1%), and 37 healthy volunteers (median age 50 years, IQR 38-56; 19 females, 51.4%). Fasting peripheral blood samples were collected on postoperative day one and seven. High performance liquid chromatography-mass spectrometry (HPLC-MS) analysis was performed. The results showed that plasma from patients after aSAH featured a distinctive amino acids concentration which was presented in both principal component analysis and direct comparison. No significant differences were noted between postoperative day one and seven. A total of 18 patients from the study group (51.4%) developed CVS. Hydroxyproline (AUC = 0.7042, 95%CI 0.5259-0.8826, p = 0.0248) and phenylalanine (AUC = 0.6944, 95%CI 0.5119-0.877, p = 0.0368) presented significant CVS prediction potential. Combining the Hunt-Hess Scale and plasma levels of hydroxyproline and phenylalanine provided the model with the best predictive performance and the lowest leave-one-out cross-validation of performance error. Our results suggest that plasma amino acids may improve sensitivity and specificity of Hunt-Hess scale in predicting CVS.
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Affiliation(s)
- Ernest Jan Bobeff
- Department of Neurosurgery and Neuro-Oncology, Medical University of Lodz, Barlicki University Hospital, Kopcinskiego St. 22, 90-153 Lodz, Poland; (K.W.); (M.P.); (D.J.J.)
- Correspondence: ; Tel.: +48-42-677-6770; Fax: +48-42-677-6781
| | - Malgorzata Bukowiecka-Matusiak
- Department of Structural Biology, Medical University of Lodz, 90-419 Lodz, Poland; (M.B.-M.); (I.B.-P.); (D.S.); (L.A.W.)
| | - Konrad Stawiski
- Department of Biostatistics and Translational Medicine, Medical University of Lodz, Mazowiecka 15 Street, 92-215 Lodz, Poland;
| | - Karol Wiśniewski
- Department of Neurosurgery and Neuro-Oncology, Medical University of Lodz, Barlicki University Hospital, Kopcinskiego St. 22, 90-153 Lodz, Poland; (K.W.); (M.P.); (D.J.J.)
| | - Izabela Burzynska-Pedziwiatr
- Department of Structural Biology, Medical University of Lodz, 90-419 Lodz, Poland; (M.B.-M.); (I.B.-P.); (D.S.); (L.A.W.)
| | - Magdalena Kordzińska
- Department of Radiology, Barlicki Memorial Teaching Hospital, Medical University of Lodz, Kopcinskiego 22 Street, 90-153 Lodz, Poland; (M.K.); (L.S.)
| | - Konrad Kowalski
- Laboratorium Diagnostyczne Masdiag, ul. Żeromskiego 33, 01-882 Warszawa, Poland; (K.K.); (P.S.)
| | - Przemyslaw Sendys
- Laboratorium Diagnostyczne Masdiag, ul. Żeromskiego 33, 01-882 Warszawa, Poland; (K.K.); (P.S.)
| | - Michał Piotrowski
- Department of Neurosurgery and Neuro-Oncology, Medical University of Lodz, Barlicki University Hospital, Kopcinskiego St. 22, 90-153 Lodz, Poland; (K.W.); (M.P.); (D.J.J.)
| | - Dorota Szczesna
- Department of Structural Biology, Medical University of Lodz, 90-419 Lodz, Poland; (M.B.-M.); (I.B.-P.); (D.S.); (L.A.W.)
| | - Ludomir Stefańczyk
- Department of Radiology, Barlicki Memorial Teaching Hospital, Medical University of Lodz, Kopcinskiego 22 Street, 90-153 Lodz, Poland; (M.K.); (L.S.)
| | - Lucyna Alicja Wozniak
- Department of Structural Biology, Medical University of Lodz, 90-419 Lodz, Poland; (M.B.-M.); (I.B.-P.); (D.S.); (L.A.W.)
| | - Dariusz Jan Jaskólski
- Department of Neurosurgery and Neuro-Oncology, Medical University of Lodz, Barlicki University Hospital, Kopcinskiego St. 22, 90-153 Lodz, Poland; (K.W.); (M.P.); (D.J.J.)
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Abstract
Nitric oxide is an important mediator of vascular autoregulation and is involved in pathophysiological changes after acute neurological disorders. Nitric oxide is generated by nitric oxide synthases from the amino acid L-arginine. L-arginine can also serve as a substrate for arginases or lead to the generation of dimethylarginines, asymmetric dimethylarginine, and symmetric dimethylarginine, by methylation. Asymmetric dimethylarginine is an endogenous inhibitor of nitric oxide synthase and can lead to endothelial dysfunction. This review discusses the role of L-arginine metabolism in patients suffering from acute and critical neurological disorders often requiring neuro-intensive care treatment. Conditions addressed in this review include intracerebral hemorrhage, aneurysmal subarachnoid hemorrhage, and traumatic brain injury. Recent therapeutic advances in the field are described including current randomized controlled trials for traumatic brain injuries and hemorrhagic stroke.
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Affiliation(s)
- Marius Marc-Daniel Mader
- Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Patrick Czorlich
- Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Zimmermann J, Weller J, Grub S, Kebir S, Lehmann F, Vatter H, Schuss P, Güresir E, Müller M. Arginase-1 Released into CSF After Aneurysmal Subarachnoid Hemorrhage Decreases Arginine/Ornithine Ratio: a Novel Prognostic Biomarker. Transl Stroke Res 2021; 13:382-390. [PMID: 34599427 PMCID: PMC9046143 DOI: 10.1007/s12975-021-00944-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 08/13/2021] [Accepted: 09/06/2021] [Indexed: 11/03/2022]
Abstract
We hypothesized that the enzyme arginase-1 is released into the cerebrospinal fluid (CSF) during red blood cell lysis and contributes to dysregulated metabolism of the nitric oxide (NO) precursor L-arginine during aneurysmal subarachnoid hemorrhage (SAH). This prospective case-control study included 43 patients with aneurysmal SAH and ventricular drainage for clinical reasons. Longitudinal CSF samples (99) were obtained in the course of SAH. Patients were dichotomized regarding the occurrence of cerebral vasospasm syndrome (CVS) (N = 19). Arginase-1 and the amino acids L-arginine and L-ornithine were quantified in CSF. Outcome assessments included delayed cerebral ischemia (DCI) and functional status after 3 months using the modified Rankin Scale (mRS). Arginase-1 was released into the CSF of SAH patients whereas this enzyme was undetectable in controls. Compared to patients without CVS, arginase-1 levels were higher in CVS patients until day 14 after clinical event. The well-known surrogate parameter for arginase acitivity, the L-arginine to L-ornithine ratio (Arg/Orn), correlated with CSF arginase-1 levels. Arg/Orn was reduced in patients with CVS from disease onset (days 1-3, p = 0.0009) until day 14. Logistic regression analysis of early Arg/Orn was predictive for CVS (p = 0.008) and DCI (p = 0.035), independent of age, Hunt and Hess grade, and intraventricular blood. Arg/Orn < 2.71 at disease onset predicted CVS with a sensitivity of 86.7% and specificity of 72.2%. Arg/Orn ≥ 2.71 predicted excellent functional outcome. We propose a novel mechanism contributing to NO deprivation during SAH: arginase-1 is released from erythrocytes into the CSF, leading to L-arginine consumption and reduced NO bioavailability. Furthermore, Arg/Orn is a robust predictor for occurrence of CVS, DCI, and functional outcome 3 months after aneurysmal SAH. Our data provide a novel prognostic biomarker and may contribute to the development of novel therapeutic strategies in SAH. Clinical Trial Registration-URL: http://www.drks.de . Unique identifier: DRKS00015293, date of registration: 13.09.2018.
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Affiliation(s)
- Julian Zimmermann
- Department of Neurology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
| | - Johannes Weller
- Department of Neurology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Sven Grub
- Department of Neurology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Sied Kebir
- Department of Neurology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Felix Lehmann
- Department of Anaesthesiology and Intensive Care, University Hospital Bonn, Bonn, Germany
| | - Hartmut Vatter
- Department of Neurosurgery, University Hospital Bonn, Bonn, Germany
| | - Patrick Schuss
- Department of Neurosurgery, University Hospital Bonn, Bonn, Germany
| | - Erdem Güresir
- Department of Neurosurgery, University Hospital Bonn, Bonn, Germany
| | - Marcus Müller
- Department of Neurology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
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Anan M, Nagai Y, Fudaba H, Fujiki M. Lactate and Lactate Dehydrogenase in Cistern as Biomarkers of Early Brain Injury and Delayed Cerebral Ischemia of Subarachnoid Hemorrhage. J Stroke Cerebrovasc Dis 2020; 29:104765. [DOI: 10.1016/j.jstrokecerebrovasdis.2020.104765] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 02/07/2020] [Accepted: 02/13/2020] [Indexed: 01/02/2023] Open
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Appel D, Seeberger M, Schwedhelm E, Czorlich P, Goetz AE, Böger RH, Hannemann J. Asymmetric and Symmetric Dimethylarginines are Markers of Delayed Cerebral Ischemia and Neurological Outcome in Patients with Subarachnoid Hemorrhage. Neurocrit Care 2018; 29:84-93. [DOI: 10.1007/s12028-018-0520-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Jorgensen A, Staalsoe JM, Simonsen AH, Hasselbalch SG, Høgh P, Weimann A, Poulsen HE, Olsen NV. Progressive DNA and RNA damage from oxidation after aneurysmal subarachnoid haemorrhage in humans. Free Radic Res 2017; 52:51-56. [PMID: 29157018 DOI: 10.1080/10715762.2017.1407413] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Free radical toxicity is considered as a key mechanism in the neuronal damage occurring after aneurysmal subarachnoid haemorrhage (SAH). We measured markers of DNA and RNA damage from oxidation (8-oxodG and 8-oxoGuo, respectively) in cerebrospinal fluid from 45 patients with SAH on day 1-14 after ictus and 45 age-matched healthy control subjects. At baseline, both markers were significantly increased in patients compared to controls (p values < .001), and exhibited a progressive further increase (to >20-fold above control levels) from day 5-14. None of the markers predicted the occurrence of vasospasms or mortality, although there was a trend that the 8-oxoGuo marker was more strongly associated with mortality than the 8-oxodG marker. We conclude that SAH leads to a massive increase in damage to nucleic acids from oxidative stress, which is likely to play a role in neuronal dysfunction and death. As only patients in need of a ventriculostomy catheter were included in the study, the findings cannot necessarily be extrapolated to all patients with SAH.
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Affiliation(s)
- Anders Jorgensen
- a Psychiatric Centre Copenhagen , Copenhagen , Denmark.,b Department of Biomedicine, Faculty of Health and Medical Sciences , University of Copenhagen , Copenhagen , Denmark
| | - Jonatan M Staalsoe
- c Department of Neurology , University Hospital Bispebjerg , Copenhagen , Denmark
| | - Anja H Simonsen
- d Danish Dementia Research Centre, Department of Neurology , University Hospital Rigshospitalet , Copenhagen , Denmark
| | - Steen G Hasselbalch
- b Department of Biomedicine, Faculty of Health and Medical Sciences , University of Copenhagen , Copenhagen , Denmark.,d Danish Dementia Research Centre, Department of Neurology , University Hospital Rigshospitalet , Copenhagen , Denmark
| | - Peter Høgh
- b Department of Biomedicine, Faculty of Health and Medical Sciences , University of Copenhagen , Copenhagen , Denmark.,e Department of Neurology , University Hospital Zealand , Roskilde , Denmark
| | - Allan Weimann
- f Laboratory of Clinical Pharmacology Q7642 , University Hospital Rigshospitalet , Copenhagen , Denmark.,g Department of Clinical Pharmacology , University Hospital Bispebjerg , Copenhagen , Denmark
| | - Henrik E Poulsen
- b Department of Biomedicine, Faculty of Health and Medical Sciences , University of Copenhagen , Copenhagen , Denmark.,f Laboratory of Clinical Pharmacology Q7642 , University Hospital Rigshospitalet , Copenhagen , Denmark.,g Department of Clinical Pharmacology , University Hospital Bispebjerg , Copenhagen , Denmark
| | - Neils V Olsen
- b Department of Biomedicine, Faculty of Health and Medical Sciences , University of Copenhagen , Copenhagen , Denmark.,h Department of Neuroanaesthesia, the Neuroscience Centre , University Hospital Rigshospitalet , Copenhagen , Denmark
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Wiśniewski J, Fleszar MG, Piechowicz J, Krzystek-Korpacka M, Chachaj A, Szuba A, Lorenc-Kukula K, Masłowski L, Witkiewicz W, Gamian A. A novel mass spectrometry-based method for simultaneous determination of asymmetric and symmetric dimethylarginine, l
-arginine and l
-citrulline optimized for LC-MS-TOF and LC-MS/MS. Biomed Chromatogr 2017; 31. [DOI: 10.1002/bmc.3994] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 03/20/2017] [Accepted: 04/19/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Jerzy Wiśniewski
- Department of Medical Biochemistry; Wroclaw Medical University; Wroclaw Poland
| | - Mariusz G. Fleszar
- Department of Medical Biochemistry; Wroclaw Medical University; Wroclaw Poland
| | - Joanna Piechowicz
- Department of Medical Biochemistry; Wroclaw Medical University; Wroclaw Poland
| | | | - Angelika Chachaj
- Department of Angiology; Wroclaw Medical University; Wroclaw Poland
- Department of Internal Medicine; 4th Military Hospital; Wroclaw Poland
| | - Andrzej Szuba
- Department of Angiology; Wroclaw Medical University; Wroclaw Poland
- Department of Internal Medicine; 4th Military Hospital; Wroclaw Poland
| | - Katarzyna Lorenc-Kukula
- Shimadzu Center For Advanced Analytical Chemistry; The University of Texas at Arlington; TX USA
| | - Leszek Masłowski
- Department of Vascular Surgery; Regional Specialist Hospital; Wroclaw Poland
| | - Wojciech Witkiewicz
- Department of Surgical Oncology; Regional Specialist Hospital; Wroclaw Poland
- Research and Development Center at Regional Specialist Hospital; Wroclaw Poland
| | - Andrzej Gamian
- Department of Medical Biochemistry; Wroclaw Medical University; Wroclaw Poland
- Wroclaw Research Center EIT+; Wroclaw Poland
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8
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High Levels of Methylarginines Were Associated With Increased Mortality in Patients With Severe Sepsis. Shock 2016; 46:365-72. [DOI: 10.1097/shk.0000000000000649] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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9
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Cakir M, Calikoglu C, Yılmaz A, Akpinar E, Bayraktutan Z, Topcu A. Serum nesfatin-1 levels: a potential new biomarker in patients with subarachnoid hemorrhage*. Int J Neurosci 2016; 127:154-160. [DOI: 10.3109/00207454.2016.1153473] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Murteza Cakir
- Faculty of Medicine, Department of Neurosurgery, Ataturk University, Erzurum, Turkey
| | - Cagatay Calikoglu
- Faculty of Medicine, Department of Neurosurgery, Ataturk University, Erzurum, Turkey
| | - Atilla Yılmaz
- Faculty of Medicine, Department of Neurosurgery, Mustafa Kemal University, Hatay, Turkey
| | - Erol Akpinar
- Faculty of Medicine, Department of Pharmacology, Ataturk University, Erzurum, Turkey
| | - Zafer Bayraktutan
- Department of Biochemistry, Erzurum Region Education and Research Hospital, Erzurum, Turkey
| | - Atilla Topcu
- Faculty of Medicine, Department of Pharmacology, Ataturk University, Erzurum, Turkey
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Lindgren C, Söderberg S, Koskinen LOD, Hultin M, Edvardsson L, Naredi S. Long-term subarachnoid haemorrhage survivors still die due to cerebrovascular causes. Acta Neurol Scand 2015; 132:410-6. [PMID: 25864536 DOI: 10.1111/ane.12410] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2015] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Subarachnoid haemorrhage (SAH) is associated with sympathetic nervous activation and inflammation. SAH could therefore theoretically be a risk factor for development of cardiovascular disease. The aim of this study was to investigate whether long-term (≥1 year) SAH survivors had an increased risk of death due to cardiovascular causes. MATERIAL & METHODS SAH patients ≥18 years treated at Umeå University Hospital between 1986 and 2006 were eligible for inclusion. Deceased patients were identified in the Swedish population register. Death certificates from long-term SAH survivors and causes of death in the general population were obtained from the National Board of Health and Welfare, Sweden. The prevalence of comorbidities at the time of SAH was compared with the distribution of cardiovascular risk factors in the northern Sweden MONICA (Multinational Monitoring of Trends and Determinants in Cardiovascular Disease) health survey. Analyses were stratified for age and sex. RESULTS In the SAH patients, the median year of SAH was 1992 and the median year of death was 2001. The MONICA survey in 1994 and the distribution of deaths in the general population in 2001 were used for comparison. Long-term SAH survivors had, compared to the general population, a significantly increased risk for death due to cerebrovascular disease (P < 0.0001), but not for death due to cardiovascular disease. Hypertension was more common in SAH patients compared to survey participants (P < 0.01). CONCLUSION Cerebrovascular causes of death were significantly more common in long-term survivors after SAH compared to the general population.
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Affiliation(s)
- C. Lindgren
- Department of Surgical and Perioperative Sciences; Anaesthesiology and Intensive Care; Umeå University; Umeå Sweden
| | - S. Söderberg
- Department of Public Health and Clinical Medicine; Medicine; Umeå University; Umeå Sweden
| | - L.-O. D. Koskinen
- Department of Pharmacology and Clinical Neuroscience; Neurosurgery; Umeå University; Umeå Sweden
| | - M. Hultin
- Department of Surgical and Perioperative Sciences; Anaesthesiology and Intensive Care; Umeå University; Umeå Sweden
| | - L. Edvardsson
- Department of Public Health and Clinical Medicine; Medicine; Umeå University; Umeå Sweden
| | - S. Naredi
- Department of Anaesthesiology and Intensive Care; Institute of Clinical Sciences; Sahlgrenska Academy at the University of Gothenburg; Gothenburg Sweden
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Hussain S, Barbarite E, Chaudhry NS, Gupta K, Dellarole A, Peterson EC, Elhammady MS. Search for Biomarkers of Intracranial Aneurysms: A Systematic Review. World Neurosurg 2015; 84:1473-83. [DOI: 10.1016/j.wneu.2015.06.034] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Revised: 06/15/2015] [Accepted: 06/16/2015] [Indexed: 11/16/2022]
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12
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Jorgensen A, Knorr U, Soendergaard MG, Lykkesfeldt J, Fink-Jensen A, Poulsen HE, Jorgensen MB, Olsen NV, Staalsø JM. Asymmetric dimethylarginine in somatically healthy schizophrenia patients treated with atypical antipsychotics: a case-control study. BMC Psychiatry 2015; 15:67. [PMID: 25880260 PMCID: PMC4394403 DOI: 10.1186/s12888-015-0455-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 03/23/2015] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Schizophrenia is associated with increased cardiovascular morbidity and mortality. Asymmetric dimethylarginine (ADMA), an endogenous inhibitor of the nitric oxide synthase, and the L-arginine:ADMA ratio are markers of endothelial dysfunction that predict mortality and adverse outcome in a range of cardiovascular disorders. Increased ADMA levels may also lead to increased oxidative stress. We hypothesized that ADMA and the L-arginine:ADMA ratio are increased in somatically healthy schizophrenia patients treated with atypical antipsychotics (AAP), and that the ADMA and the L-arginine: ADMA ratio are positively correlated to measures of oxidative stress. METHODS We included 40 schizophrenia patients treated with AAP, but without somatic disease or drug abuse, and 40 healthy controls. Plasma concentrations of ADMA and L-arginine were determined by high-performance liquid chromatography. Data were related to markers of systemic oxidative stress on DNA, RNA and lipids, as well as measures of medication load, duration of disease and current symptomatology. RESULTS Plasma ADMA and the L-arginine:ADMA ratio did not differ between schizophrenia patients and controls. Furthermore, ADMA and the L-arginine:ADMA ratio showed no correlations with oxidative stress markers, medication load, or Positive and Negative Syndrome Scale scores. CONCLUSIONS Schizophrenia and treatment with AAP was not associated with increased levels of plasma ADMA or the L-arginine:ADMA ratio. Furthermore, plasma levels of ADMA were not associated with levels of systemic oxidative stress in vivo.
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Affiliation(s)
- Anders Jorgensen
- Psychiatric Centre Copenhagen, University Hospital of Copenhagen, Copenhagen, Denmark. .,Department of Neuroscience and Pharmacology, Laboratory of Neuropsychiatry, University of Copenhagen, Copenhagen, Denmark. .,Psychiatric Centre Copenhagen, University Hospital of Copenhagen, Rigshospitalet, Blegdamsvej 9, DK-2100, Copenhagen, Denmark.
| | - Ulla Knorr
- Psychiatric Centre Copenhagen, University Hospital of Copenhagen, Copenhagen, Denmark.
| | | | - Jens Lykkesfeldt
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Anders Fink-Jensen
- Psychiatric Centre Copenhagen, University Hospital of Copenhagen, Copenhagen, Denmark. .,Department of Neuroscience and Pharmacology, Laboratory of Neuropsychiatry, University of Copenhagen, Copenhagen, Denmark. .,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Henrik Enghusen Poulsen
- Laboratory of Clinical Pharmacology Q7642, Rigshospitalet, Copenhagen, Denmark. .,Department of Clinical Pharmacology, Bispebjerg Hospital, Copenhagen, Denmark. .,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Martin Balslev Jorgensen
- Psychiatric Centre Copenhagen, University Hospital of Copenhagen, Copenhagen, Denmark. .,Department of Neuroscience and Pharmacology, Laboratory of Neuropsychiatry, University of Copenhagen, Copenhagen, Denmark. .,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Niels Vidiendal Olsen
- Department of Neuroscience and Pharmacology, Laboratory of Neuropsychiatry, University of Copenhagen, Copenhagen, Denmark. .,Department of Neuroanaesthesia, The Neuroscience Centre, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark.
| | - Jonatan Myrup Staalsø
- Department of Neuroscience and Pharmacology, Laboratory of Neuropsychiatry, University of Copenhagen, Copenhagen, Denmark.
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Shiue I. Urinary thiocyanate concentrations are associated with adult cancer and lung problems: US NHANES, 2009-2012. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2015; 22:5952-5960. [PMID: 25367645 DOI: 10.1007/s11356-014-3777-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 10/26/2014] [Indexed: 06/04/2023]
Abstract
Links between environmental chemicals and human health have emerged but the effects from perchlorate, nitrate and thiocyanate were unclear. Therefore, it was aimed to study the relationships of urinary perchlorate, nitrate and thiocyanate concentrations and adult health conditions in a national and population-based study. Data was retrieved from US National Health and Nutrition Examination Surveys, 2009-2012, including demographics, blood pressure readings, self-reported health conditions and urinary perchlorate, nitrate and thiocyanate concentrations. Analyses included chi-square test, t test survey-weighted logistic regression models and population attributable risk estimation. There were no clear associations between urinary perchlorate concentrations and adult health conditions, although people with hearing loss and diabetes could be at the borderline risk. Urinary thiocyanate concentrations were significantly associated with emphysema (odds ratio (OR) 2.70 95% confidence intervals (CI) 1.91-3.82, P < 0.001), cancer (OR 1.21 95%CI 1.06-1.39, P = 0.008), chronic bronchitis (OR 1.23 95%CI 1.10-1.52, P = 0.003), wheezing (OR 1.24 95%CI 1.05-1.46, P = 0.011), coughing (OR 1.19 95%CI 1.03-1.37, P = 0.018) and sleep complaints (OR 1.14 95%CI 1.02-1.26, P = 0.019). The population attributable risks accounted for 3.3% (1.8-5.3%), 1.9% (0.6-3.5%), 1.2% (0.5-2.6%), 2.2% (0.5-4.1%), 1.8% (0.3-6.2%) and 1.3% (0.2-2.4%) for emphysema, cancer, chronic bronchitis, wheezing, coughing and sleep complaints, respectively. In addition, there was an inverse association observed between urinary nitrate level and heart failure. This is for the first time observing significant risk effects of urinary thiocyanate concentrations on adult cancer and lung problems, although the causality cannot be established. Elimination of such environmental chemical in humans should be included in future health policy and intervention programs.
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Affiliation(s)
- Ivy Shiue
- School of the Built Environment, Heriot-Watt University, Riccarton, EH14 4AS, Edinburgh, Scotland, UK,
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14
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Plasma arginine/ADMA ratio as a sensitive risk marker for atherosclerosis: Shimane CoHRE study. Atherosclerosis 2014; 239:61-6. [PMID: 25576847 DOI: 10.1016/j.atherosclerosis.2014.12.030] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 11/26/2014] [Accepted: 12/17/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND Asymmetric dimethylarginine (ADMA), which acts an endogenous inhibitor of nitric oxide synthase (NOS), is involved in the pathogenesis of cardiovascular disease. Arginine (Arg) may regulate vascular endothelial function, since Arg is the substrate of NO competing with ADMA. In our previous study, low Arg/ADMA ratio is an independent risk for microangiopathy-related cerebral damage. PURPOSE Here, we performed a cross-sectional study to evaluate the association between the Arg/ADMA ratio and the maximal intima-media thickness (IMT) in the carotid artery. SUBJECTS AND METHODS Participants were 785 community-dwelling Japanese people without any severe disorders. Plasma concentration of Arg and ADMA in fasting blood sample was determined using HPLC. IMT was measured in the bilateral carotid artery by ultrasonography. RESULTS Among quartiles stratified by the Arg/ADMA ratio, ANOVA showed a significant difference in IMT and the IMT in Q1 (the lowest quartile) was significantly higher than that in Q4 (the highest quartile). In multiple linear regression analysis, age, the male gender, lower BMI, the presence of hypertension and lower Arg/ADMA ratio were independently correlated with IMT, while IMT was not correlated with Arg or ADMA alone. In addition, the Arg/ADMA ratio was associated with IMT independent of age, sex, BMI and the presence of hypertension with odds ratio 0.21 (95%CI: 0.05-0.88) in multiple logistic regression analysis for IMT 1.5 mm or more. CONCLUSION Imbalance of Arg and ADMA is independently involved in the progression of atherosclerosis, and the Arg/ADMA ratio may be a sensitive marker for atherosclerosis.
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Abstract
PURPOSE OF REVIEW This article reviews recent advances in the postoperative ICU management of patients after subarachnoid hemorrhage (SAH), especially with regards to hemodynamic management, methods of improving neurological outcomes, and management of cardiac and pulmonary complications. RECENT FINDINGS Several hemodynamic monitors and parameters may be useful for guiding volume therapy, including cardiac output, stroke volume variation monitoring, and global end-diastolic volume index. Early goal-directed hemodynamic therapy after SAH has recently been shown to improve clinical outcomes in patients with a poor clinical grade or coexisting cardiopulmonary complications. Recent laboratory and imaging modalities are being developed to identify patients at risk for developing vasospasm after SAH. Evidence for the use of various prophylactic adjuvant therapies to prevent vasospasm, including magnesium, phosphodiesterase 3 inhibitors, and therapeutic hypothermia, is emerging. Intrathecal administration of vasodilators or fibrinolytics may have offered advantages over systemic drug administration in the treatment of vasospasm. Pulmonary and cardiac complications are common after SAH, and are associated with an increased risk of mortality. SUMMARY The postoperative ICU period after SAH is associated with a significant morbidity and mortality risk, and recent studies have greatly contributed to our understanding of how to optimally manage these patients.
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Affiliation(s)
- Shaun E. Gruenbaum
- Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Fedrico Bilotta
- Department of Anesthesiology, Critical Care and Pain Medicine, ‘Sapienza’ University of Rome, Rome, Italy
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Increased cerebrospinal fluid concentrations of asymmetric dimethylarginine correlate with adverse clinical outcome in subarachnoid hemorrhage patients. J Clin Neurosci 2014; 21:1404-8. [DOI: 10.1016/j.jocn.2013.11.038] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Accepted: 11/13/2013] [Indexed: 11/18/2022]
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Evaluation of endothelial function by peripheral arterial tonometry and relation with the nitric oxide pathway. Nitric Oxide 2014; 42:1-8. [PMID: 25064180 DOI: 10.1016/j.niox.2014.07.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 04/30/2014] [Accepted: 07/10/2014] [Indexed: 10/25/2022]
Abstract
Endothelial dysfunction is an important component in the development of cardiovascular diseases. Endothelial function may be evaluated by peripheral arterial tonometry (PAT) which measures the vasodilator function in the microvasculature of the fingertip during reactive hyperaemia. The reactive hyperaemia index (RHI) is decreased in the presence of cardiovascular risk factors and thus far several studies have shown that PAT-RHI may provide reliable prediction of outcome. The technique is operator independent and easy to perform. Abnormalities measured by PAT follow the same trend as those measured by flow-mediated dilation in the brachial artery, but the two methods are not interchangeable. We have reviewed the recent literature in an effort to evaluate peripheral arterial tonometry as a method to assess the function of the endothelium and additionally suggest directions for future research. Special attention will be directed to the nitric oxide dependency of the reactive hyperaemia index obtained by peripheral arterial tonometry.
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Chen S, Feng H, Sherchan P, Klebe D, Zhao G, Sun X, Zhang J, Tang J, Zhang JH. Controversies and evolving new mechanisms in subarachnoid hemorrhage. Prog Neurobiol 2014; 115:64-91. [PMID: 24076160 PMCID: PMC3961493 DOI: 10.1016/j.pneurobio.2013.09.002] [Citation(s) in RCA: 270] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 09/07/2013] [Accepted: 09/12/2013] [Indexed: 12/13/2022]
Abstract
Despite decades of study, subarachnoid hemorrhage (SAH) continues to be a serious and significant health problem in the United States and worldwide. The mechanisms contributing to brain injury after SAH remain unclear. Traditionally, most in vivo research has heavily emphasized the basic mechanisms of SAH over the pathophysiological or morphological changes of delayed cerebral vasospasm after SAH. Unfortunately, the results of clinical trials based on this premise have mostly been disappointing, implicating some other pathophysiological factors, independent of vasospasm, as contributors to poor clinical outcomes. Delayed cerebral vasospasm is no longer the only culprit. In this review, we summarize recent data from both experimental and clinical studies of SAH and discuss the vast array of physiological dysfunctions following SAH that ultimately lead to cell death. Based on the progress in neurobiological understanding of SAH, the terms "early brain injury" and "delayed brain injury" are used according to the temporal progression of SAH-induced brain injury. Additionally, a new concept of the vasculo-neuronal-glia triad model for SAH study is highlighted and presents the challenges and opportunities of this model for future SAH applications.
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Affiliation(s)
- Sheng Chen
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Department of Physiology & Pharmacology, Loma Linda University, Loma Linda, CA, USA
| | - Hua Feng
- Department of Neurosurgery, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Prativa Sherchan
- Department of Physiology & Pharmacology, Loma Linda University, Loma Linda, CA, USA
| | - Damon Klebe
- Department of Physiology & Pharmacology, Loma Linda University, Loma Linda, CA, USA
| | - Gang Zhao
- Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shanxi, China
| | - Xiaochuan Sun
- Department of Neurosurgery, First Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Jianmin Zhang
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jiping Tang
- Department of Physiology & Pharmacology, Loma Linda University, Loma Linda, CA, USA
| | - John H Zhang
- Department of Physiology & Pharmacology, Loma Linda University, Loma Linda, CA, USA; Department of Neurosurgery, Loma Linda University, Loma Linda, CA, USA.
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Bergström A, Staalsø J, Romner B, Olsen N. Impaired endothelial function after aneurysmal subarachnoid haemorrhage correlates with arginine:asymmetric dimethylarginine ratio † †This article is accompanied by Editorial I. Br J Anaesth 2014; 112:311-8. [DOI: 10.1093/bja/aet331] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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Scherbakov N, Doehner W. I. Peripheral endothelial dysfunction after subarachnoid haemorrhage: what the fingertips can tell us. Br J Anaesth 2014; 112:205-6. [DOI: 10.1093/bja/aet443] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lindgren C, Hultin M, Koskinen LOD, Lindvall P, Borota L, Naredi S. ADMA Levels and Arginine/ADMA Ratios Reflect Severity of Disease and Extent of Inflammation After Subarachnoid Hemorrhage. Neurocrit Care 2014; 21:91-101. [DOI: 10.1007/s12028-013-9945-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Tsuda K. Letter by Tsuda Regarding Article, “Low Plasma Arginine:Asymmetric Dimethyl Arginine Ratios Predict Mortality After Intracranial Aneurysm Rupture”. Stroke 2013; 44:e92. [DOI: 10.1161/strokeaha.113.001910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Kazushi Tsuda
- Cardiovascular and Metabolic Research Center, Kansai University of Health Sciences, Osaka, Japan
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Staalsø JM, Romner B, Olsen NV. Response to Letter Regarding Article, “Low Plasma Arginine:Asymmetric Dimethyl Arginine Ratios Predict Mortality After Intracranial Aneurysm Rupture”. Stroke 2013; 44:e93. [DOI: 10.1161/strokeaha.113.001915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Jonatan Myrup Staalsø
- Department of Neuroscience and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Bertil Romner
- Department of Neurosurgery, Copenhagen University Hospital, The Neuroscience Centre, Copenhagen, Denmark
| | - Niels Vidiendal Olsen
- Department of Neuroanaesthesia, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
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