Biomarkers as outcome predictors in subarachnoid hemorrhage – a systematic review

Hong, Caron M.; Tosun, Çiğdem; Kurland, David B.; Gerzanich, Volodymyr; Schreibman, David L.; Simard, J. Marc

doi:10.3109/1354750x.2014.881418

Cited by 61 publications

(47 citation statements)

References 116 publications

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“…Increased concentrations of S100 calcium binding proteinb (S100b), C-reactive protein, adhesion and matrix molecules, and vasogenic and cardiac markers have been found in aSAH patients with poor outcomes, but the limited accuracy of most of these markers has hampered their use in clinical practice. 13,27,36,38 Neopterin, a catabolic product of GTP (guanosine-5-triphosphate) produced by human monocytes-macrophages upon stimulation with interferon-g, has been reported as an outcome and infection biomarker for several inflammatory diseases. 6,19,35 Moreover, Mathiesen et al showed that the CSF and plasma concentrations of neopterin were higher in patients suffering from aSAH than in controls.…”

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confidence: 99%

Neopterin plasma concentrations in patients with aneurysmal subarachnoid hemorrhage: correlation with infection and long-term outcome

Azurmendi

Degos

Tiberti

et al. 2016

JNS

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A neurysmAl subarachnoid hemorrhage (aSAH) is a subtype of stroke associated with high rates of mortality and morbidity. Fifteen percent of patients die before arriving at a hospital, and 25% of deaths occur within the first 24 hours. 34 Among the survivors, 30% will develop a long-term delayed neurological deficit that will affect their quality of life. 21,32The long-term outcome partially depends on early diagnosis and management.1,12 Therefore, if an aneurysm is detected by CT in a patient with aSAH, invasive treatment is indicated to prevent a second hemorrhage from the affected vessel, the most important cause of death in the first 24 hours following aSAH. 20,25 Large studies, such as the International Subarachnoid Aneurysm Trial (ISAT), have investigated whether neurosurgical clipping or endovascular coiling improve the long-term outcome. It has been abbreviatioNs aSAH = aneurysmal subarachnoid hemorrhage; AUC = area under the ROC curve; DCI = delayed cerebral ischemia; EVD = external ventricular drain; GCS = Glasgow Coma Scale; GOS = Glasgow Outcome Scale; NSE = neuron-specific enolase; ROC = receiver operating characteristic; ROS = reactive oxygen species; S100b = S100 calcium binding protein-b; WBC = white blood cell; WFNS = World Federation of Neurosurgical Societies. obJective Aneurysmal subarachnoid hemorrhage (aSAH) is associated with high rates of mortality and morbidity. The main predictor for the poor outcome is the World Federation of Neurosurgical Societies (WFNS) scale. However, this scale does not take into account proinflammatory events, such as infection occurring after the aSAH, which could modify the long-term status of patients. The aim of this study was to evaluate neopterin as an inflammatory biomarker for outcome and infection prediction in aSAH patients. methods Plasma concentrations of neopterin were measured in 61 aSAH patients (22 male and 39 female; mean age [± SD] 52.8 ± 11.8 years) using a commercial ELISA kit. Samples were collected daily for 10 days. Outcome at 12 months was determined using the Glasgow Outcome Scale (GOS) and dichotomized as poor (GOS score 1, 2, or 3) or good (GOS score 4 or 5). Infection was determined by the presence of a positive bacterial culture. results Patients with poor outcome at 12 months had higher concentrations of neopterin than patients with good outcome. In the same way, patients who had an infection during the hospitalization had significantly higher concentrations of neopterin than patients without infection (p = 0.001). Moreover, neopterin concentrations were significantly (p < 0.008) elevated in infected patients 2 days before infection detection and antibiotic therapy. coNclusioNs Neopterin is an efficient outcome predictor after aSAH. Furthermore, it is able to differentiate between infected and uninfected patients as early as 2 days before clinical signs of infection, facilitating earlier antibiotic therapy and better management.

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confidence: 99%

Neopterin plasma concentrations in patients with aneurysmal subarachnoid hemorrhage: correlation with infection and long-term outcome

Azurmendi

Degos

Tiberti

et al. 2016

JNS

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“…Once alpha-2-macroglobulin is activated and bound to a cytokine, it is rapidly removed from the circulation by the hepatic alpha-2-macroglobulin receptor. Increased clearance of alpha-2-macroglobulin, in response to elevated levels of inflammatory cytokines associated with cerebral vasospasm 9,10 , is a possible explanation for our finding of decreased levels in patients who developed vasospasm.…”

Section: Discussionmentioning

confidence: 63%

Multiplexed protein profiling after aneurysmal subarachnoid hemorrhage: Characterization of differential expression patterns in cerebral vasospasm

Walcott

Patel

Stapleton

et al. 2014

Journal of Clinical Neuroscience

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Cerebral vasospasm is major contributor to delayed morbidity following aneurysmal subarachnoid hemorrhage. We sought to evaluate differential plasma protein levels across time in patients with aneurysmal subarachnoid hemorrhage to identify potential biomarkers and to better understand the pathogenesis of cerebral vasospasm. Nine female patients with aneurysmal subarachnoid hemorrhage underwent serial analysis of 239 different serum protein levels using quantitative, multiplexed immunoassays (DiscoveryMAP 250+ v2.0, Mryiad RBM, Austin, TX USA) on post-hemorrhage days 0 and 5. A repeated measures analysis of variance determined that mean protein concentration decreased significantly in patients who developed vasospasm versus those who did not for alpha-2-macroglobulin (F [1.00, 7.00] = 16.33, p = 0.005), angiogenin (F [1.00, 7.00] = 7.65, p = 0.028), apolipoprotein A-IV (F [1.00, 7.00] = 6.308, p = 0.040), granulocyte colony-stimulating factor (F [1.00, 7.00] = 9.08, p = 0.020), macrophage-stimulating protein (F [1.00, 7.00] = 24.21, p = 0.002), tetranectin (F [1.00, 7.00] = 5.46, p < 0.039), vascular endothelial growth factor receptor 3 (F [1.00, 7.00] = 6.94, p = 0.034), and significantly increased for vitronectin (F [1.00, 7.00] = 5.79, p = 0.047). These biomarkers may be of value in detecting cerebral vasospasm, possibly aiding in the identification of patients at high-risk prior to neurological deterioration.

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“…Entzündungsreaktion und Mikrothrombosen ▼ Dieses Feld wird bislang immer noch durch die tierexperimentelle Forschung dominiert, allerdings werden zunehmend Liquoranalysen und Mikrodialyseverfahren in vivo angewendet, um die pathophysiologischen Assoziationen von Cytokinen, Chemokinen, Metalloproteinasen und Nekrosefaktoren nach stattgehabter SAB oder nach SHT zu untersuchen. Überwiegend wurde der Einfluss auf die Genese von angiografisch nachgewiesenen Vasospasmen evaluiert, jedoch konnten hier keine kongruenten Ergebnisse gezeigt werden [62][63][64]. In kürzlich veröffentlichten Meta-Analysen konnten verschiedene Biomarkern identifiziert werden, die eine Korrelation mit der Prognose nach SAB bzw.…”

Section: Methoden Zur Invasiven Zerebralen Blutflussmessungunclassified

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Kuramatsu¹,

Huttner²,

Staykov³

2015

Akt Neurol

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Biomarkers as outcome predictors in subarachnoid hemorrhage – a systematic review

Cited by 61 publications

References 116 publications

Neopterin plasma concentrations in patients with aneurysmal subarachnoid hemorrhage: correlation with infection and long-term outcome

Neopterin plasma concentrations in patients with aneurysmal subarachnoid hemorrhage: correlation with infection and long-term outcome

Multiplexed protein profiling after aneurysmal subarachnoid hemorrhage: Characterization of differential expression patterns in cerebral vasospasm

Was gibt es Neues zum Thema invasives Neuromonitoring?

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