Early Dynamics of Interleukin-6 in Cerebrospinal Fluid after Aneurysmal Subarachnoid Hemorrhage

Ďuriš, Kamil; Neuman, Eduard; Vybíhal, Václav; Juráň, Vilém; Gottwaldová, Jana; Kýr, Michal; Vašků, Anna; Smrčka, Martin

doi:10.1055/s-0037-1604084

Cited by 18 publications

(15 citation statements)

References 30 publications

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“…However, neuroinflammation after SAH plays an important role in the pathophysiologic events of EBI, as mentioned above, and proinflammatory cytokines, such as IL-1β, IL-6, and TNF-α, are mediators of those immunologic reactions and are associated with the neurologic outcome [24,25]. Therefore, we intend to further study the effect of SGB on the changes of inflammatory cytokine levels and cerebral blood vessels during EBI and to discuss the effect of SGB on the clinical prognosis of patients with SAH.…”

Section: Introductionmentioning

confidence: 99%

Effects of stellate ganglion block on early brain injury in patients with subarachnoid hemorrhage: a randomised control trial

et al. 2021

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Background Subarachnoid hemorrhage (SAH) is a common neurosurgical emergency, and early brain injury (EBI) plays an important role in acute brain injury of SAH. Our objective is to investigate the effect of stellate ganglion block (SGB) on the clinical prognosis of patients with SAH (registration number ChiCTR2000030910). Methods A randomized controlled trial was conducted with 102 participants. Patients with SAH were assigned to the SGB or nSGB group. Patients in the SGB group received SGB four times (once every other day starting on the day of the surgery). In contrast, patients in the nSGB group only received standard care. Data were collected on the day before surgery (T0) and on the 1st (T1), 3rd (T2) and 7th day (T3) after surgery. The primary outcomes included EBI markers (including IL-1β, IL-6, TNF-α, ET-1, NPY, NSE and S100β), the mean cerebral blood flow velocity of the middle cerebral artery (Vm-MCA) and the basilar artery (Vm-BA). All cases were followed up for 6 months after surgery. Results The levels of the EBI markers in both groups were higher at T1–T3 than at T0 (P<0.05), and the Vm-MCA and Vm-BA were also increased at the same times. However, the levels of the EBI markers were lower in the SGB group than in the nSGB group (P<0.05), and the increases of Vm-MCA and Vm-BA were also lower (P<0.05). The prognosis score and neurological deficit were better in the SGB group than in the nSGB group (P<0.05). Conclusions SGB can improve the prognosis of SAH patients by inhibiting the inflammatory response during EBI and by reducing endothelial dysfunction and relieving CVS. Trial registration Clinical trial number: ChiCTR2000030910; Registry URL: Chinese Clinical Trial Registry; Principal investigator's name: Ying Nie; Date of Trial registration: March, 2020 (retrospectively registered).

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Section: Introductionmentioning

confidence: 99%

Effects of stellate ganglion block on early brain injury in patients with subarachnoid hemorrhage: a randomised control trial

et al. 2021

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“… 37 Other studies showed that the expression levels of IL-6 in CSF were associated with outcomes in aSAH patients. 21 , 25 , 33 Elevated IL-6 levels in CSF may induce neuroinflammation and may be closely linked to the progression of delayed cerebral ischemia after SAH. 24 IL-6 and TNF-α in CSF could be essential biomarkers for disease prediction and disease monitoring in SAH patients.…”

Section: Discussionmentioning

confidence: 99%

“… 14 , 23 , 24 Studies reported that elevated IL-6 levels induce neuroinflammation and may be closely associated with the outcomes of aSAH. 20 , 25 , 26 Nevertheless, screens for the expression IL-6 of sEVs in CSF of aSAH patients have not yet been reported.…”

Section: Introductionmentioning

confidence: 99%

Interleukin-6 in Cerebrospinal Fluid Small Extracellular Vesicles as a Potential Biomarker for Prognosis of Aneurysmal Subarachnoid Haemorrhage

Yang

Fang

Yuan

et al. 2021

NDT

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Aneurysmal subarachnoid hemorrhage (aSAH) is a severe form of stroke characterized by high rates of mortality and disability. Identifying circulating biomarkers is helpful to improve outcomes. In this study, for the first time, we identify interleukin-6 (IL-6) in cerebrospinal fluid (CSF) small extracellular vesicles (sEVs) as potential biomarkers for prognosis of aSAH. Methods: We extracted small extracellular vesicles from the CSF of 103 aSAH patients and 40 healthy controls in a prospective observational study. Subsequently, we measured IL-6 sEVs levels using an enzyme-linked immunosorbent assay. Results were statistically analyzed to determine the function of IL-6 sEVs for disease monitoring of aSAH. Results: CSF IL-6 sEVs showed distinct pattern differences between healthy controls and aSAH patients. The concentration of IL-6 sEVs in CSF is significantly correlated with the severity of aSAH patients. The areas under the receiver operating characteristic curves of IL-6 sEVs for identifying severe aSAH patient from aSAH patients were 0.900. After multivariate logistic regression analysis, IL-6 sEVs were associated with neurological outcome at 1 year. IL-6 sEVs levels were greater and positively associated with disease processes and outcome. Conclusion:There is a neuroinflammatory cascade in aSAH patients. IL-6 sEVs in CSF may be a biomarker for the progression of aSAH.

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“…For ST, they have anti-vasospasm and anti-in ammatory effects. Vasospasm is closely related to the DCI process after aSAH, but the in ammatory mechanism runs throughout the EBI and DCI brain injury process [48][49][50][51] . Several different trials [52][53][54][55] indicated that the e cacy of statins is still controversial, although ST failed to show a good ability to improve clinical outcome in our study, given the important role of nerve in ammation in the process of aSAH and the relative safety of ST, we believe that ST still has great potential, and may be used in combination with other drugs to produce curative effect in terms of improving the prognosis of patients with signi cant synergistic effect.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness Comparisons of Drug Therapies for Postoperative Aneurysmal Subarachnoid Hemorrhage Patients: Network Meta‑analysis and systematic review

Huang

Zhang

et al. 2021

Preprint

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Objective: To compare the effectiveness of various drug interventions in improving the clinical outcome of postoperative patients after aneurysmal subarachnoid hemorrhage (aSAH) and assist in determining the drugs of definite curative effect in improving clinical prognosis.Methods: Eligible Randomized Controlled Trials (RCTs) were searched in databases of PubMed, EMBASE, and Cochrane Library (inception to Sep 2020). Glasgow Outcome Scale (GOS) score, Extended Glasgow Outcome Scale (GOSE) score or modified Rankin Scale (mRS) score was used as the main outcome measurements to evaluate the efficacy of various drugs in improving the clinical outcomes of postoperative patients with aSAH. The network meta-analysis (NMA) was conducted based on a random-effects model, dichotomous variables were determined by using odds ratio (OR) with 95% confidence interval (CI), and a surface under the cumulative ranking curve (SUCRA) was generated to estimate the ranking probability of comparative effectiveness among different drug therapies.Results: From the 493 of initial citation screening, forty-four RCTs (n=10626 participants) were eventually included in our analysis. Our NMA results showed that cilostazol (OR=3.35,95%CI=1.50,7.51) was the best intervention to improve the clinical outcome of patients (SUCRA=87.29%, 95%CrI 0.07-0.46). Compared with the placebo group, only two drug interventions [nimodipine (OR=1.61, 95%CI 1.01,2.57) and cilostazol (OR=3.35, 95%CI 1.50, 7.51)] achieved significant statistical significance in improving the clinical outcome of patients. Conclusions: Both nimodipine and cilostazol have exact curative effect to improve the outcome of postoperative patients with aSAH, and cilostazol may be the best drug to improve the outcome of patients after aSAH operation. Our study provides implications for future studies that, the combination of two or more drugs with relative safety and potential benefits (e.g., nimodipine and cilostazol) may improve the clinical outcome of patients more effectively.

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Early Dynamics of Interleukin-6 in Cerebrospinal Fluid after Aneurysmal Subarachnoid Hemorrhage

Cited by 18 publications

References 30 publications

Effects of stellate ganglion block on early brain injury in patients with subarachnoid hemorrhage: a randomised control trial

Effects of stellate ganglion block on early brain injury in patients with subarachnoid hemorrhage: a randomised control trial

Interleukin-6 in Cerebrospinal Fluid Small Extracellular Vesicles as a Potential Biomarker for Prognosis of Aneurysmal Subarachnoid Haemorrhage

Effectiveness Comparisons of Drug Therapies for Postoperative Aneurysmal Subarachnoid Hemorrhage Patients: Network Meta‑analysis and systematic review

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