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Chen SH, Hu FL, Wang G, Liang XS, He CJ. Importance of AIM2 as a serum marker for reflecting severity and predicting a poor outcome of human severe traumatic brain injury: A prospective longitudinal cohort study. Clin Chim Acta 2024; 559:119691. [PMID: 38685373 DOI: 10.1016/j.cca.2024.119691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/17/2024] [Accepted: 04/26/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Absent in melanoma 2 (AIM2) participates in neuroinflammation. Here, the prognostic significance of serum AIM2 was explored in severe traumatic brain injury (sTBI). METHODS A total of 135 sTBI patients and 80 healthy controls were recruited in this prospective cohort study. Serum C-reactive protein (CRP) and AIM2 levels were measured. Glasgow Coma Scale (GCS) and Rotterdam computed tomography (CT) classification were recorded as the severity indicators. Prognostic parameters were posttraumatic six-month extended Glasgow outcome scale (GOSE) scores and poor outcome (GOSE scores of 1-4). RESULTS As opposed to controls, there were significantly elevated serum AIM2 levels after sTBI. Serum AIM2 levels were independently correlated with serum CRP levels, GCS scores, Rotterdam CT scores, GOSE scores and poor outcome. Also, serum AIM2 levels were efficiently predictive of poor outcome under the receiver operating characteristic (ROC) curve. Under the restricted cubic spline, serum AIM2 levels were linearly correlated with risk of poor outcome. Using subgroup analysis, serum AIM2 levels did not significantly interact with other indices, such as age, gender, alcohol drinking, cigarette smoking, etc. Also, combination model, in which serum AIM2, GCS scores and Rotterdam CT scores were merged, was outlined using nomogram and performed well under calibration curve, ROC curve and decision curve. CONCLUSIONS Raised serum AIM2 levels after sTBI, in intimate correlation with systemic inflammation and trauma severity, are independently discriminative of posttraumatic six-month neurological outcome, substantializing serum AIM2 as an inflammatory prognostic biomarker of sTBI.
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Affiliation(s)
- Si-Hua Chen
- Department of Neurosurgery, Affiliated Hospital of Shaoxing University(Shaoxing Municipal Hospital), No. 999 Zhongxing South Road, Yuecheng District, Shaoxing City 312000, Zhejiang Province, China
| | - Fang-Lin Hu
- Department of Neurosurgery, Affiliated Hospital of Shaoxing University(Shaoxing Municipal Hospital), No. 999 Zhongxing South Road, Yuecheng District, Shaoxing City 312000, Zhejiang Province, China.
| | - Gang Wang
- Department of Neurosurgery, Affiliated Hospital of Shaoxing University(Shaoxing Municipal Hospital), No. 999 Zhongxing South Road, Yuecheng District, Shaoxing City 312000, Zhejiang Province, China
| | - Xiao-Song Liang
- Department of Neurosurgery, Affiliated Hospital of Shaoxing University(Shaoxing Municipal Hospital), No. 999 Zhongxing South Road, Yuecheng District, Shaoxing City 312000, Zhejiang Province, China
| | - Chen-Jun He
- Department of Neurosurgery, Affiliated Hospital of Shaoxing University(Shaoxing Municipal Hospital), No. 999 Zhongxing South Road, Yuecheng District, Shaoxing City 312000, Zhejiang Province, China
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Wu X, Su C, Tian D, Ye Y, Du Q, Chen J, Li H, Liu J. Utility of serum chemokine-like factor 1 as a biomarker of severity and prognosis after severe traumatic brain injury: A prospective observational study. Brain Behav 2024; 14:e3522. [PMID: 38773776 PMCID: PMC11109498 DOI: 10.1002/brb3.3522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 03/20/2024] [Accepted: 04/19/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND Chemokine-like factor 1 (CKLF1) may be involved in the inflammatory response and secondary brain injury after severe traumatic brain injury (sTBI). We determined serum CKLF1 levels of sTBI patients to further investigate the correlation of CKLF1 levels with disease severity, functional prognosis, and 180-day mortality of sTBI. METHODS Serum CKLF1 levels were measured at admission in 119 sTBI patients and at entry into study in 119 healthy controls. Serum CKLF levels of 50 patients were also quantified at days 1-3, 5, and 7 after admission. Glasgow coma scale (GCS) scores and Rotterdam computerized tomography (CT) classification were utilized to assess disease severity. Extended Glasgow outcome scale (GOSE) scores were recorded to evaluate function prognosis at 180 days after sTBI. Relations of serum CKLF1 levels to 180-day poor prognosis (GOSE scores of 1-4) and 180-day mortality were analyzed using univariate analysis, followed by multivariate analysis. Receiver-operating characteristic (ROC) curve was built to investigate prognostic predictive capability. RESULTS Serum CKLF1 levels of sTBI patients increased at admission, peaked at day 2, and then gradually decreased; they were significantly higher during the 7 days after sTBI than in healthy controls. Differences of areas under ROC curve (areas under the curve [AUCs]) were not significant among the six time points. Multivariate analysis showed that serum CKLF1 levels were independently correlated with GCS scores, Rotterdam CT classification, and GOSE scores. Serum CKLF1 levels were significantly higher in non-survivors than in survivors and in poor prognosis patients than in good prognosis patients. Serum CKLF1 levels independently predicted 180-day poor prognosis and 180-day mortality, and had high 180-day prognosis and mortality predictive abilities, and their AUCs were similar to those of GCS scores and Rotterdam CT classification. Combination model containing serum CKLF1, GCS scores, and Rotterdam CT classification performed more efficiently than any of them alone in predicting mortality and poor prognosis. The models were visually described using nomograms, which were comparatively stable under calibration curve and were relatively of clinical benefit under decision curve. CONCLUSION Serum CKLF1 levels are significantly associated with disease severity, poor 180-day prognosis, and 180-day mortality in sTBI patients. Hence, complement CKLF1 may serve as a potential prognostic biomarker of sTBI.
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Affiliation(s)
- Xiaoyu Wu
- Department of NeurosurgeryThe Sixth Affiliated Hospital of Wenzhou Medical UniversityLishuiChina
- Department of NeurosurgeryLishui City People's HospitalLishuiChina
| | - Chang Su
- Department of NeurosurgeryThe Sixth Affiliated Hospital of Wenzhou Medical UniversityLishuiChina
- Department of NeurosurgeryLishui City People's HospitalLishuiChina
| | - Da Tian
- Department of NeurosurgeryThe Sixth Affiliated Hospital of Wenzhou Medical UniversityLishuiChina
- Department of NeurosurgeryLishui City People's HospitalLishuiChina
| | - Yufei Ye
- Department of NeurosurgeryQingyuan County People's HospitalQingyuanChina
| | - Qinghua Du
- Department of NeurosurgeryThe Sixth Affiliated Hospital of Wenzhou Medical UniversityLishuiChina
- Department of NeurosurgeryLishui City People's HospitalLishuiChina
| | - Junxia Chen
- Department of NeurosurgeryThe Sixth Affiliated Hospital of Wenzhou Medical UniversityLishuiChina
- Department of NeurosurgeryLishui City People's HospitalLishuiChina
| | - Huguang Li
- Department of NeurosurgeryThe Sixth Affiliated Hospital of Wenzhou Medical UniversityLishuiChina
- Department of NeurosurgeryLishui City People's HospitalLishuiChina
| | - Jin Liu
- Department of NeurosurgeryThe Sixth Affiliated Hospital of Wenzhou Medical UniversityLishuiChina
- Department of NeurosurgeryLishui City People's HospitalLishuiChina
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Yang K, Yang L, Chen X, Li J, Zheng B, Hu J, Wang H, Yu Q, Song G. Importance of serum IRAK3 as a biochemical marker in relation to severity and neurological outcome of human severe traumatic brain injury: A prospective longitudinal cohort study. Clin Chim Acta 2024; 553:117754. [PMID: 38169195 DOI: 10.1016/j.cca.2023.117754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 12/22/2023] [Accepted: 12/29/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Interleukin-1 receptor-associated kinase 3 (IRAK3) may modulate inflammation in brain immunity. We determined the prognostic role of serum IRAK3 in severe traumatic brain injury (sTBI). METHODS In this prospective longitudinal cohort study, serum IRAK3 concentrations of 131 sTBI patients and 131 controls were quantified. Extended Glasgow outcome scale (GOSE) scores of 1-4 at 180 days after trauma signified a poor prognosis. Univariate and multivariate analyses were sequentially adopted to appraise severity correlations and prognosis associations. RESULTS There were significantly higher serum IRAK3 concentrations in patients than in controls. Serum IRAK3 concentrations of patients were independently correlated with Glasgow coma scale (GCS) scores, Rotterdam computed tomography (CT) scores and posttraumatic180-day GOSE scores. Also, IRAK3 concentrations were independently associated with 180-day poor prognosis, but not with death. Prognosis prediction model, in which GCS scores, Rotterdam scores and serum IRAK3 concentrations were merged, was portrayed using the nomogram. The model was rather stable, clinically usable and efficiently discriminative of poor prognosis under calibration curve, decision curve and receiver operating characteristic curve. CONCLUSIONS A substantial enhancement of serum IRAK3 concentrations after head trauma is independently related to severity and neurological outcome, substantializing serum IRAK3 as a promising prognostic biomarker of sTBI.
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Affiliation(s)
- Kai Yang
- Department of Neurosurgery, Jiangshan People's Hospital, Jiangshan 324100, Zhejiang Province, China.
| | - Lijun Yang
- Department of Neurosurgery, Jiangshan People's Hospital, Jiangshan 324100, Zhejiang Province, China
| | - Xiaoyan Chen
- Department of Neurosurgery, Jiangshan People's Hospital, Jiangshan 324100, Zhejiang Province, China
| | - Jian Li
- Department of Neurosurgery, Jiangshan People's Hospital, Jiangshan 324100, Zhejiang Province, China
| | - Bokun Zheng
- Department of Neurosurgery, Jiangshan People's Hospital, Jiangshan 324100, Zhejiang Province, China
| | - Juheng Hu
- Department of Neurosurgery, Jiangshan People's Hospital, Jiangshan 324100, Zhejiang Province, China
| | - Hailong Wang
- Department of Neurosurgery, Jiangshan People's Hospital, Jiangshan 324100, Zhejiang Province, China
| | - Quanwang Yu
- Department of Neurosurgery, Jiangshan People's Hospital, Jiangshan 324100, Zhejiang Province, China
| | - Guangtai Song
- Department of Neurosurgery, Jiangshan People's Hospital, Jiangshan 324100, Zhejiang Province, China
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Li Y, Tao C, An N, Liu H, Liu Z, Zhang H, Sun Y, Xing Y, Gao Y. Revisiting the role of the complement system in intracerebral hemorrhage and therapeutic prospects. Int Immunopharmacol 2023; 123:110744. [PMID: 37552908 DOI: 10.1016/j.intimp.2023.110744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 07/21/2023] [Accepted: 07/29/2023] [Indexed: 08/10/2023]
Abstract
Intracerebral hemorrhage (ICH) is a stroke subtype characterized by non-traumatic rupture of blood vessels in the brain, resulting in blood pooling in the brain parenchyma. Despite its lower incidence than ischemic stroke, ICH remains a significant contributor to stroke-related mortality, and most survivors experience poor outcomes that significantly impact their quality of life. ICH has been accompanied by various complex pathological damage, including mechanical damage of brain tissue, hematoma mass effect, and then leads to inflammatory response, thrombin activation, erythrocyte lysis, excitatory amino acid toxicity, complement activation, and other pathological changes. Accumulating evidence has demonstrated that activation of complement cascade occurs in the early stage of brain injury, and the excessive complement activation after ICH will affect the occurrence of secondary brain injury (SBI) through multiple complex pathological processes, aggravating brain edema, and pathological brain injury. Therefore, the review summarized the pathological mechanisms of brain injury after ICH, specifically the complement role in ICH, and its related pathological mechanisms, to comprehensively understand the specific mechanism of different complements at different stages after ICH. Furthermore, we systematically reviewed the current state of complement-targeted therapies for ICH, providing a reference and basis for future clinical transformation of complement-targeted therapy for ICH.
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Affiliation(s)
- Yuanyuan Li
- Key Laboratory of Chinese Internal Medicine of Ministry of Education, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China; Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing 100700, China
| | - Chenxi Tao
- Key Laboratory of Chinese Internal Medicine of Ministry of Education, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
| | - Na An
- Key Laboratory of Chinese Internal Medicine of Ministry of Education, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
| | - Haoqi Liu
- Key Laboratory of Chinese Internal Medicine of Ministry of Education, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
| | - Zhenhong Liu
- Key Laboratory of Chinese Internal Medicine of Ministry of Education, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China; Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing 100700, China
| | - Hongrui Zhang
- Key Laboratory of Chinese Internal Medicine of Ministry of Education, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
| | - Yikun Sun
- Key Laboratory of Chinese Internal Medicine of Ministry of Education, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
| | - Yanwei Xing
- Guang'an Men Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China.
| | - Yonghong Gao
- Key Laboratory of Chinese Internal Medicine of Ministry of Education, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China; Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing 100700, China.
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Tang B, Zhong Z, Wu J, Ma J, Li L, Zhong X, Lin D, Hu J, Yu P. Evaluation of Serum NLRC4 as a Potential Prognostic Biochemical Marker in Humans with Severe Traumatic Brain Injury: A Prospective Cohort Study. Risk Manag Healthc Policy 2023; 16:439-454. [PMID: 36994425 PMCID: PMC10042254 DOI: 10.2147/rmhp.s404877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 03/15/2023] [Indexed: 03/31/2023] Open
Abstract
Objective Involvement of NLR CARD domain containing 4 (NLRC4) in neuroinflammation has been demonstrated. The aim of this study was to ascertain the prognostic role of serum NLRC4 in severe traumatic brain injury (sTBI). Methods In this prospective cohort study including 140 sTBI patients and 140 controls, serum NLRC4 levels were quantified. Follow-up time was 180 days after trauma and poor prognosis was designated as extended Glasgow outcome scale (GOSE) scores of 1-4. Severity correlations and prognosis associations were determined under multivariate models. Results Enhanced serum NLRC4 levels after sTBI, in comparison to controls (median, 0.8 ng/mL versus 0.1 ng/mL; P < 0.001), were independently correlated with Glasgow coma scale (GCS) scores (β, -0.091; 95% confidence interval (CI), -0.161-0.021; P = 0.011), Rotterdam computed tomography (CT) scores (β, 0.136; 95% CI, 0.024-0.248; P = 0.018), serum C-reactive protein levels (β, 0.016; 95% CI, 0.002-0.030; P = 0.025) and 180-day GOSE scores (β, -0.906; 95% CI, -1.632-0.180; P = 0.015); and were independently predictive of 180-day death (odds ratio, 4.307; 95% CI, 1.706-10.879; P = 0.014)), overall survival (hazard ratio, 2.360; 95% CI, 1.118-4.981; P = 0.040) and poor prognosis (odds ratio, 6.705; 95% CI, 2.889-15.561; P = 0.016). Under receiver operating characteristic curve, combination of serum NLRC4 levels, GCS scores and Rotterdam CT scores had significantly higher death predictive ability than Rotterdam CT scores (P = 0.040), but not than GCS scores (P = 0.070); and exhibited substantially higher predictive capability for poor prognosis than Rotterdam CT scores (P < 0.001) and GCS scores alone (P = 0.023). Conclusion There is a dramatical elevation of serum NLRC4 levels after sTBI, which has strong correlation with severity and inflammation, and is significantly associated with long-term death and poor outcome, substantializing serum NLRC4 as an inflammatory, prognostic biomarker in sTBI.
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Affiliation(s)
- Bei Tang
- Department of Critical Care Medicine, The First People’s Hospital of Jiande City, Jiande, People’s Republic of China
| | - Ze Zhong
- Department of Critical Care Medicine, The First People’s Hospital of Jiande City, Jiande, People’s Republic of China
- Correspondence: Ze Zhong, Department of Critical Care Medicine, The First People’s Hospital of Jiande City, Jiande, People’s Republic of China, Tel/Fax +86 571 64096607, Email
| | - Jinping Wu
- Department of Critical Care Medicine, The First People’s Hospital of Jiande City, Jiande, People’s Republic of China
| | - Jianping Ma
- Department of Critical Care Medicine, The First People’s Hospital of Jiande City, Jiande, People’s Republic of China
| | - Li Li
- Department of Critical Care Medicine, The First People’s Hospital of Jiande City, Jiande, People’s Republic of China
| | - Xuzheng Zhong
- Department of Critical Care Medicine, The First People’s Hospital of Jiande City, Jiande, People’s Republic of China
| | - Dongmei Lin
- Department of Critical Care Medicine, The First People’s Hospital of Jiande City, Jiande, People’s Republic of China
| | - Jiayuan Hu
- Department of Critical Care Medicine, The First People’s Hospital of Jiande City, Jiande, People’s Republic of China
| | - Pingan Yu
- Department of Critical Care Medicine, The First People’s Hospital of Jiande City, Jiande, People’s Republic of China
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Zhang W, Chen Y, Pei H. C1q and central nervous system disorders. Front Immunol 2023; 14:1145649. [PMID: 37033981 PMCID: PMC10076750 DOI: 10.3389/fimmu.2023.1145649] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 03/07/2023] [Indexed: 04/11/2023] Open
Abstract
C1q is a crucial component of the complement system, which is activated through the classical pathway to perform non-specific immune functions, serving as the first line of defense against pathogens. C1q can also bind to specific receptors to carry out immune and other functions, playing a vital role in maintaining immune homeostasis and normal physiological functions. In the developing central nervous system (CNS), C1q functions in synapse formation and pruning, serving as a key player in the development and homeostasis of neuronal networks in the CNS. C1q has a close relationship with microglia and astrocytes, and under their influence, C1q may contribute to the development of CNS disorders. Furthermore, C1q can also have independent effects on neurological disorders, producing either beneficial or detrimental outcomes. Most of the evidence for these functions comes from animal models, with some also from human specimen studies. C1q is now emerging as a promising target for the treatment of a variety of diseases, and clinical trials are already underway for CNS disorders. This article highlights the role of C1q in CNS diseases, offering new directions for the diagnosis and treatment of these conditions.
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Affiliation(s)
- Wenjie Zhang
- Department of Emergency Intensive Care Unit, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of General Practice, Xingyang Sishui Central Health Center, Zhengzhou, China
| | - Yuan Chen
- Department of Neurology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hui Pei
- Department of Emergency Intensive Care Unit, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Hui Pei,
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The differences in serum C1q levels between first-episode patients with bipolar disorder and major depressive disorder. J Psychosom Res 2022; 162:111042. [PMID: 36156342 DOI: 10.1016/j.jpsychores.2022.111042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 09/11/2022] [Accepted: 09/12/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE This study aimed at exploring the changes of serum complement C1q levels in patients with Bipolar Disorder (BD) using a cross-sectional design, and the differences between Major Depressive Disorder (MDD) and BD. Moreover, the correlation between complement C1q and bech-rafaelsdn mania rating scales (BRMS) in patients with MDD and BD was assessed. METHODS Serum complement C1q levels were measured by ADVIA 2400 biochemical analyser in 104 patients with MDD, 71 patients with BD type I and 42 patients with BD type II diagnosed by Diagnostic and Statistical of Mental Disorder 5 (DSM-5). Then simple and multivariate linear regression analysis was conducted between the level of serum C1q and BRMS among patients with BD. RESULTS The serum complement C1q levels were higher in BD type I than BD type II (P < 0.001); Serum complement C1q levels were higher in MDD than BD type II (P < 0.001). We discovered that there was a positive correlation relationship between serum complement C1q levels and BRMS in BD type I (r = 0.756, P < 0.001). CONCLUSION We confirmed that serum complement C1q levels were higher in patients with BD type II than in MDD patients. These current results support the view that the complement C1q may play an important role in the pathophysiology of BD. Serum complement C1q was strongly associated with BD and is worth investigating in future studies.
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Wang Z, Wu X, Yan T, Liu M, Yu W, Du Q, Hu W, Zheng Y, Zhang Z, Wang K, Dong X. Elevated Plasma Complement C1q Levels Contribute to a Poor Prognosis After Acute Primary Intracerebral Hemorrhage: A Prospective Cohort Study. Front Immunol 2022; 13:920754. [PMID: 35812425 PMCID: PMC9259799 DOI: 10.3389/fimmu.2022.920754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022] Open
Abstract
Objective The complement cascade is activated early following intracerebral hemorrhage (ICH) and causes acute brain injury. We intended to explore the effects of plasma complement component 1q (C1q) levels on hemorrhagic severity and functional outcome in ICH patients. Methods In this prospective cohort study, we measured the plasma C1q levels of 101 ICH patients and 101 healthy controls. The Glasgow Coma Scale (GCS) score and hematoma volume were used to assess the ICH severity. Poor prognosis was referred to as a Glasgow Outcome Scale (GOS) score of 1-3 at three months following a stroke. A multivariate logistic regression model was configured to determine the independent relation of plasma C1q levels to severity and poor prognosis. Under receiver operating characteristic (ROC) curve, prognostic capability of plasma C1q levels was evaluated. Results There was a significant elevation of plasma C1q levels in patients, as compared to controls [median (percentiles 25th-75th), 225.04 mg/l (156.10-280.15 mg/l) versus 88.18 mg/l (70.12-117.69 mg/l); P<0.001]. Plasma C1q levels of patients were independently related to GCS score (t =-3.281, P=0.001) and hematoma volume (t = 2.401, P=0.018), and were highly correlated with the GOS score at 3 months post-stroke (r=-0.658, P<0.001). Plasma C1q levels were obviously higher in poor prognosis patients than in other remainders (median percentiles 25th-75th), 278.40 mg/l (213.81-340.05 mg/l) versus 174.69 mg/l (141.21-239.93 mg/l); P<0.001). Under the ROC curve, plasma C1q levels significantly discriminated the development of poor prognosis (area under ROC curve 0.795; 95% confidence interval, 0.703–0.869; P<0.001). Using maximum Youden method, plasma C1q levels > 270.11 mg/l distinguished patients at risk of poor prognosis at 3 months with 56.52% sensitivity and 94.55% specificity. Meanwhile, the prognostic predictive ability of plasma C1q levels was equivalent to those of GCS score and hematoma volume (both P>0.05). Moreover, plasma C1q levels > 270.11 mg/l independently predicted a poor prognosis at 3 months (odds ratio, 4.821; 95% confidence interval, 1.211-19.200; P=0.026). Conclusion Plasma C1q levels are closely related to the illness severity and poor prognosis of ICH at 3 months. Hence, complement C1q may play an important role in acute brain injury after ICH and plasma C1q may represent a promising prognostic predictor of ICH.
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Affiliation(s)
- Zefan Wang
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiaoyu Wu
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Tian Yan
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Ming Liu
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Wenhua Yu
- Department of Neurosurgery, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Quan Du
- Department of Neurosurgery, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wei Hu
- Department of Intensive Care Unit, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yongke Zheng
- Department of Intensive Care Unit, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zuyong Zhang
- Department of Neurosurgery, Xixi Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Keyi Wang
- Central Laboratory, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaoqiao Dong
- Department of Neurosurgery, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- *Correspondence: Xiaoqiao Dong,
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Jiang F, Chen Z, Hu J, Liu Q. Serum NOX4 as a Promising Prognostic Biomarker in Association with 90-Day Outcome of Severe Traumatic Brain Injury. Int J Gen Med 2022; 15:5307-5317. [PMID: 35669593 PMCID: PMC9165705 DOI: 10.2147/ijgm.s366170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 05/24/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Nicotinamide adenine dinucleotide phosphate oxidase 4 (NOX4) is related to brain oxidative stress. We attempted to examine the association between serum NOX4 levels, severity and prognosis of severe traumatic brain injury (sTBI). Methods We measured serum NOX4 levels in 105 patients with sTBI. Trauma severity was assessed using Glasgow coma scale (GCS) and Rotterdam computed tomography (CT) classification. Study outcome data on death and worst outcome (Glasgow outcome scale score of 1-3) were collected at 90 days after trauma. Multivariate analyses were performed to determine independent factors for overall survival and worst outcome. Area under receiver operating characteristic curve (AUC) was estimated to assess prognostic predictive ability. Results Serum NOX4 levels were tightly correlated with GCS score (t=-5.843, P < 0.001) and Rotterdam CT score (t = 4.231, P < 0.001). During 90 days of follow-up, 50 participants (47.6%) experienced a worse outcome, 28 (26.7%) died and the mean overall survival time was 71.9 days (95% confidence interval (CI), 65.7-78.1 days). Serum NOX4 was independently associated with an increased risk of short overall survival (hazard ratio, 1.129; 95% CI, 1.039-1.228) or worse outcome (odds ratio, 1.053; 95% CI, 1.014-1.095). Serum NOX4 levels had a certain predictive value for the patient's risk of mortality (AUC, 0.803; 95% CI, 0.714-0.874) or worse outcome (AUC, 0.780; 95% CI, 0.689-0.855). Moreover, its AUC was in the range of GCS score and Rotterdam CT score (both P > 0.05) and it significantly improved their AUCs (both P < 0.05). Conclusion Serum NOX4 levels in the acute phase of sTBI were associated with trauma severity, an increased risk of mortality and worse outcome, suggesting that serum NOX4 could be an important prognostic factor for sTBI.
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Affiliation(s)
- Feng Jiang
- Department of Neurosurgery, Ningbo Hangzhou Bay Hospital, Ningbo, 315336, People’s Republic of China
- Department of Neurosurgery, Ningbo Branch, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Ningbo, 315336, People’s Republic of China
| | - Zhicheng Chen
- Department of Neurosurgery, Ningbo Hangzhou Bay Hospital, Ningbo, 315336, People’s Republic of China
- Department of Neurosurgery, Ningbo Branch, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Ningbo, 315336, People’s Republic of China
| | - Jiemiao Hu
- Department of Neurosurgery, Ningbo Hangzhou Bay Hospital, Ningbo, 315336, People’s Republic of China
- Department of Neurosurgery, Ningbo Branch, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Ningbo, 315336, People’s Republic of China
| | - Qianzhi Liu
- Department of Neurosurgery, Ningbo Hangzhou Bay Hospital, Ningbo, 315336, People’s Republic of China
- Department of Neurosurgery, Ningbo Branch, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Ningbo, 315336, People’s Republic of China
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Paiva WS, Ortiz J, Amorim RL. Elevated Serum Complement C1q Levels After Traumatic Brain Injury [Letter]. Neuropsychiatr Dis Treat 2022; 18:951-952. [PMID: 35547264 PMCID: PMC9080997 DOI: 10.2147/ndt.s370436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 04/21/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Wellingson Silva Paiva
- Division of Neurosurgery, Department of Neurology, Hospital das Clínicas da Faculdade de Medicina, University of São Paulo, São Paulo, Brazil.,LIM 62, Laboratory of Medical Investigation in Neurosurgery, Hospital das Clínicas da Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| | - Josimar Ortiz
- Division of Neurosurgery, Department of Neurology, Hospital das Clínicas da Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| | - Robson Luis Amorim
- LIM 62, Laboratory of Medical Investigation in Neurosurgery, Hospital das Clínicas da Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
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