期刊
NEUROSURGICAL REVIEW
卷 45, 期 1, 页码 807-817出版社
SPRINGER
DOI: 10.1007/s10143-021-01607-0
关键词
Delayed cerebral ischemia; HMGB1; Inflammation; Subarachnoid hemorrhage
资金
- Homburger Forschungsforderung (HOMFOR 2018)
- Dr. Theiss Research Award 2017
The study investigated the role of HMGB1 in aneurysmal subarachnoid hemorrhage and found that admission HMGB1 levels were an independent predictor for delayed cerebral ischemia. Initial insult burden and radiological vasospasm were correlated with HMGB1 levels, but serial HMGB1 levels were not associated with cerebral ischemia, functional outcome, or radiological vasospasm.
High mobility group box 1 protein (HMGB1) is a prototypical damage associated particle and acts as a key player in aseptic inflammation. HMGB1 appears critical for the crosstalk of a prothrombotic and proinflammatory state that is implicated in mediating and exacerbating ischemic brain injury. The role of HMGB1 in aneurysmal subarachnoid hemorrhage (aSAH) remains to be elucidated. A prospective, single blinded observational study was designed to investigate the role of HMGB1 in aSAH. Serial serum HMGB1 level quantification on admission day 0, 4, 8, and 12 was performed. Primary outcome measures were delayed cerebral ischemia (DCI - new infarction on CT) and poor functional outcome (90-day modified Rankin Scale 4-6). The role of HMGB1 levels for DCI, functional outcome and radiological vasospasm prediction was analyzed. Collectively, 83 aSAH patients were enrolled. Five patients died within 48 h. In 29/78 patients (37.2%), DCI was identified. In multivariable analysis, radiological vasospasm and admission HMGB1 were independent predictors for DCI. Younger age and higher white blood cell count, but not insult burden (World Federation of Neurosurgical Societies scale, modified Fisher scale, intraparenchymal or intraventricular hematoma existence) correlated with admission HMGB1 levels. Serial HMGB1 levels did not differ between patients with or without DCI, poor functional outcome or radiological vasospasm development. Admission serum HMGB1 does not reflect initial insult burden but serves as an independent biomarker predictive of DCI. Further studies are warranted to disentangle the role of HMGB1 surrounding the sequelae of aSAH.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据