Evaluation of alpha-II-spectrin breakdown products as potential biomarkers for early recognition and severity of aneurysmal subarachnoid hemorrhage

Abstract

This study assessed whether cytoskeletal protein alpha-II spectrin breakdown products (SBDP150, SBDP145, and SBDP120) would identify the presence of aSAH and be associated with severity (GCS score, WFNS grade and survival to hospital discharge). This prospective case-control study, conducted at a tertiary care Level I trauma center, enrolled adult patients with angiography confirmed aSAH who underwent ventriculostomy placement for cerebrospinal fluid (CSF) drainage. There were 40 patients enrolled in the study, 20 with aSAH and 20 control subjects. Patients with aSAH were a mean age of 54 (SD15) and 75% were female. There were significant differences in SBDP150, SBDP145, and SBDP120 CSF levels between patients with and without aSAH (p < 0.001), even in those presenting with a GCS Score of 15 and a WFNS Grade 1. The AUC for distinguishing aSAH from control subjects was 1.0 for SBDP150 and SBDP145, and 0.95 for SBDP120. SBDP150 and SBDP145 both yielded sensitivities and specificities of 100% and SBDP120 was 90% and 100% respectively. Moreover, there were significantly higher levels of SBDP150 and SBDP145 in the non-survivors than in the survivors (p < 0.001). This study demonstrates the potential that SBDP’s have as biomarkers for recognition and severity of aSAH. A larger prospective study is warranted.

Calpastatin peptide attenuates early brain injury following experimental subarachnoid hemorrhage

“…Cerebral inflammation, oxidative stress and neuronal apoptosis are involved in the pathogenesis of EBI following SAH (1,2,5,6). Previous clinical studies reported that the 120, 145 and 150 kDa fragments of the 280 kDa neuronal cytoskeletal protein α-II spectrin are elevated in the cerebrospinal fluid of patients with SAH, and revealed that these fragments are potential biomarkers for the severity of aneurysmal SAH (7)(8)(9)(10). A previous experimental SAH study also reported that α-II spectrin fragments were elevated in a rat SAH model (11).…”

TAT-HSP27 Peptide Improves Neurologic Deficits via Reducing Apoptosis After Experimental Subarachnoid Hemorrhage

“…Compared to intracerebral microdialysis, CSF analysis may reflect a more general picture of brain injury. CSF analysis basing on lumbar puncture is cornerstone for aSAH diagnosis, which means that changes of proteins can be detected quickly and conveniently to clarify the correlation between these changes and SAH pathology (Wasik et al, 2017 ; Papa et al, 2018 ; Kwan et al, 2019 ). To our knowledge, this study is the first to report the change of CSF HSP27 in patients with aSAH as compared with patients with NPH, showing a trend of increasing first and then decreasing in the early days.…”

Clinical utility of degradomics as predictors of complications and clinical outcome in aneurysmal subarachnoid hemorrhage

“…Table 1 (Ref. [19][20][21][22][23][24][25][26][27][28][29]) summarizes the degradomic profile of aSAH regarding the prediction of severity and clinical outcome. Degradomics related to vasospasm are summarized in Table 2 (Ref.…”

“…In [20] enrolled 20 patients with aSAH and 20 controls and found a cutoff level of 2.0 ADU (arbitrary densitometric units) of SBDP150 and a 0.5 ADU of SBDP145 to distinguish between the two groups with sensitivity and specificity of 100%. A cutoff value of 0.5 ADU of SBDP120 was 90% sensitive and 100% specific.…”

“…SBDP150, SBDP145, and SBDP120 levels were higher in subgroups with a GCS score of 15 and WFNS Grade 1 compared to the control group with no aSAH. This can prevent the false assumption of normality and delayed neurological investigations for this subgroup, increasing the risk of delayed neurological damage [20]. In addition, the breakdown products level in those presenting with a GCS of 15 was lower than any other GCS scores [20].…”