Correlation between plasma total nitric oxide levels and cerebral vasospasm and clinical outcome in patients with aneurysmal subarachnoid hemorrhage in Indian population

Abstract

Context:Cerebral vasospasm remains a major cause of morbidity and mortality in patients with aneurysmal subarachnoid hemorrhage (aSAH). Reduced bioavailability of nitric oxide has been associated with the development of cerebral vasospasm after aSAH. Such data is not available in Indian population.Aims:The objective of the study was to measure the plasma total nitric oxide (nitrite and nitrate-NOx) level in aSAH patients and healthy controls treated at a tertiary hospital in India and to investigate a possible association between plasma total nitric oxide level and cerebral vasospasm and clinical outcome following treatment in patients with aSAH.Settings and Design:A case-control study of aSAH patients was conducted. Plasma total NOx levels were estimated in aSAH patients with and without vasospasm and compared the results with NOx levels in healthy individuals.Materials and Methods:aSAH in patients was diagnosed on the basis of clinical and neuro-imaging findings. Plasma total NOx levels in different subject groups were determined by Griess assay.Results:Plasma total NOx level was found to be significantly decreased in patients with aSAH when compared to controls. Plasma total NOx level in the poor-grade SAH group was lower than that in the good-grade SAH group. Plasma total NOx level further reduced in patients with angiographic (P < 0.05) and clinical vasospasm.Conclusions:Reduced plasma NOx level is seen in aSAH patients as compared to normal individuals. In aSAH patients reduced levels are associated with increased incidence of cerebral vasospasm and poor outcome. Plasma total NOx level could be used as a candidate biomarker for predicting vasospasm and outcome for this pathology.

Effect of Metformin and Sitagliptin on Doxorubicin-Induced Cardiotoxicity in Rats: Impact of Oxidative Stress, Inflammation, and Apoptosis

“…Interestingly, while metformin has significantly ameliorated the increase of NO x as compared to DOX group, it increased NO x level as compared to control and sitagliptin groups. It is already well known that NO may represent a double edged sword with pleotropic physiological as well as some serious deleterious effects in case of overproduction [ 32 ]. Zhang and colleagues have shown that the improvement in cardiac structure and function following metformin treatment in a rat model of ventricular hypertrophy was associated with enhanced eNOS and increased NO production [ 33 ].…”

The role of nitric oxide in stroke

“… 107 (5) Reduced levels of NO are associated with increased incidence of cerebral vasospasm and poor outcome in SAH patients. 108 (6) Estrogen increases the level of NO in brain and peripheral vascular endothelial cells, and alleviates the vascular spasm after SAH. 109 (7) Progesterone reduces cerebral vasospasm induced by SAH via upregulating eNOS through Akt signaling pathway.…”

Methods for diagnosing endothelial dysfunction

“…В ходе реакции образуется окрашенный диазопродукт с максимумом поглощения при длине волны 548 нм. Так как реактив Грисса выявляет только нитриты, проводят реакции восстановления нитратов в нитриты с помощью либо нитратредуктазы, либо металла ванадия (III) [27,28].…”