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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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Tjerkstra M, Labib H, Coert BA, Spijker R, Coutinho JM, Vandertop WP, Verbaan D. Laboratory biomarkers of delayed cerebral ischemia following subarachnoid hemorrhage: A systematic review. J Circ Biomark 2023; 12:17-25. [PMID: 37056917 PMCID: PMC10087563 DOI: 10.33393/jcb.2023.2502] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 03/20/2023] [Indexed: 04/08/2023] Open
Abstract
Delayed cerebral ischemia (DCI) substantially contributes to disability and death in subarachnoid hemorrhage (SAH) patients; however, its pathophysiology is incompletely understood and diagnostic and therapeutic strategies are lacking. Biomarkers may help to elucidate the pathophysiology, optimize early diagnosis, or provide treatment targets. We systematically searched PubMed and Embase on October 13, 2021, for studies that evaluated at least one laboratory biomarker in patients with DCI, using the most up-to-date definition of DCI as proposed by a panel of experts in 2010. Quality of studies was assessed using the Newcastle-Ottawa Scale or Cochrane Collaboration’s risk of bias assessment tool. Biomarkers of clinical and radiological DCI were analyzed separately. Results were meta-analyzed if possible, otherwise narratively reviewed. Biomarkers were classified as significant, inconclusive, or nonsignificant. We defined validated biomarkers as those with significant results in meta-analyses, or in at least two studies using similar methodologies within the same time interval after SAH. The search yielded 209 articles with 724 different biomarkers; 166 studies evaluated 646 biomarkers of clinical DCI, of which 141 were significant and 7 were validated biomarkers (haptoglobulin 2-1 and 2-2, ADAMTS13, vWF, NLR, P-selectin, F2-isoprostane); 78 studies evaluated 165 biomarkers of radiological DCI, of which 63 were significant and 1 was a validated biomarker (LPR). Hence, this review provides a selection of seven biomarkers of clinical DCI and one biomarker of radiological DCI as most promising biomarkers of DCI. Future research should focus on determining the exact predictive, diagnostic, and therapeutic potentials of these biomarkers.
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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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