Inflammatory cytokine cascade released by leukocytes in cerebrospinal fluid after subarachnoid hemorrhage

Takizawa, Takeomi; Tada, Tsuyoshi; Kitazawa, Kazuo; Tanaka, Yuichiro; Hongo, Kazuhiro; Kameko, Mitsuaki; Uemura, Keiichi

doi:10.1179/016164101101199243

Cited by 116 publications

(82 citation statements)

References 11 publications

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“…Interleukin-6 constitutes a strong stimulus for CRP synthesis by hepatocytes. 44,63 Additionally, IL-1, which has been implicated in the pathogenesis of cerebral vasospasm, also represents a strong stimulus for CRP synthesis. 63 Therefore, elevated concentrations of CRP may well be associated with an increased possibility of developing cerebral vasospasm and subsequently a DIND.…”

Section: Discussionmentioning

confidence: 99%

“…11,55 Additionally, it has been demonstrated that CRP, an acute-phase protein, which is a highly sensitive indicator of inflammatory response, is produced by hepatocytes in response to increased production of IL-6. 6,44,63 Because IL-6 has been associated with the development of cerebral vasospasm, increased levels of CRP at the time of the patients' admissions and early in their postictal courses might have some predictive value in the early detection and proper management of vasospasm.…”

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confidence: 99%

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Serum and cerebrospinal fluid C-reactive protein levels as predictors of vasospasm in aneurysmal subarachnoid hemorrhage

Fountas¹,

Τάσιου²,

Kapsalaki

et al. 2009

FOC

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Object Cerebral vasospasm is a common and potentially devastating complication of aneurysmal subarachnoid hemorrhage (aSAH). Inflammatory processes seem to play a major role in the pathogenesis of vasospasm. The Creactive protein (CRP) constitutes a highly sensitive inflammatory marker. The association of elevated systemic CRP and coronary vasospasm has been well established. Additionally, elevation of the serum CRP levels has been demonstrated in patients with aSAH. The purpose of the current study was to evaluate the possible relationship between elevated CRP levels in the serum and CSF and the development of vasospasm in patients with aSAH. Methods . A total of 41 adult patients in whom aSAH was diagnosed were included in the study. Their demographics, the admitting Glasgow Coma Scale (GCS) score, Hunt and Hess grade, Fisher grade, CT scans, digital subtraction angiography studies, and daily neurological examinations were recorded. Serial serum and CSF CRP measurements were obtained on Days 0, 1, 2, 3, 5, 7, and 9. All patients underwent either surgical or endovascular treatment within 48 hours of their admission. The outcome was evaluated using the Glasgow Outcome Scale and the modified Rankin Scale. Results The CRP levels in serum and CSF peaked on the 3rd postadmission day, and the CRP levels in CSF were always higher than the serum levels. Patients with lower admission GCS scores and higher Hunt and Hess and Fisher grades had statistically significantly higher levels of CRP in serum and CSF. Patients with angiographic vasospasm had higher CRP measurements in serum and CSF, in a statistically significant fashion (p < 0.0001). Additionally, patients with higher CRP levels in serum and CSF had less favorable outcome in this cohort. Conclusions Patients with aSAH who had high Hunt and Hess and Fisher grades and low GCS scores showed elevated CRP levels in their CSF and serum. Furthermore, patients developing angiographically proven vasospasm demonstrated significantly elevated CRP levels in serum and CSF, and increased CRP measurements were strongly associated with poor clinical outcome in this cohort.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Serum and cerebrospinal fluid C-reactive protein levels as predictors of vasospasm in aneurysmal subarachnoid hemorrhage

Fountas¹,

Τάσιου²,

Kapsalaki

et al. 2009

FOC

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“…In an experimental rat model of ICH, IL-6 up-regulation peaked 12 h after ICH and was related to glial activation (43). Early increase of IL-6 and IL-10 CSF concentrations after ICH (44) or severe traumatic brain injury (34,45,46) indicate its important role in mediating inflammatory response. In our study population, IL-6 and IL-10 concentrations in the CSF were found to be in a low range in all patient groups.…”

Section: Discussionmentioning

confidence: 99%

Vascular Endothelial Growth Factor and Transforming Growth Factor-β1 Are Highly Expressed in the Cerebrospinal Fluid of Premature Infants with Posthemorrhagic Hydrocephalus

et al. 2004

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“…4,9,19,22) Fasudil is believed to prevent Y. Suzuki et al delayed cerebral vasospasm and subsequent ischemic injury through the inhibition of Rho-kinase which reduces vasoconstriction, 3,12,13) occurrence of endothelial damage, 10,15,21) hyperviscosity, 6) and inflammatory responses.…”

Section: Introductionmentioning

confidence: 99%

Safety and Efficacy of Fasudil Monotherapy and Fasudil-Ozagrel Combination Therapy in Patients With Subarachnoid Hemorrhage: Sub-analysis of the Post-marketing Surveillance Study

Suzuki

Shibuya

Satoh

et al. 2008

Neurol. Med. Chir.(Tokyo)

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Sub-analysis of the fasudil post-marketing surveillance study compared the safety and efficacy of fasudil plus ozagrel to fasudil only. A total of 3690 patients received fasudil and 1138 received fasudil plus ozagrel between 1995 and 2000. The occurrence of adverse events, occurrence of low density areas associated with vasospasm on computed tomography, absence of symptomatic vasospasm, and poor clinical outcomes associated with vasospasm were compared between the fasudil and fasudil plus ozagrel groups. The pharmacokinetics of fasudil were assessed in 5 patients with subarachnoid hemorrhage. The drug interaction between fasudil and ozagrel was pharmacologically investigated in vitro and in vivo. The occurrence of adverse events and clinical outcomes were similar between the two groups. The occurrences of symptomatic vasospasm and low density areas were lower in the fasudil group than in the fasudil plus ozagrel group. The average trough value (8-hour value) of the fasudil active metabolite, hydroxyfasudil, was 50 nM. Fasudil showed no pharmacological interaction with ozagrel. The combination of fasudil plus ozagrel was well tolerated, but did not result in better efficacy than fasudil only.

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Inflammatory cytokine cascade released by leukocytes in cerebrospinal fluid after subarachnoid hemorrhage

Cited by 116 publications

References 11 publications

Serum and cerebrospinal fluid C-reactive protein levels as predictors of vasospasm in aneurysmal subarachnoid hemorrhage

Serum and cerebrospinal fluid C-reactive protein levels as predictors of vasospasm in aneurysmal subarachnoid hemorrhage

Vascular Endothelial Growth Factor and Transforming Growth Factor-β1 Are Highly Expressed in the Cerebrospinal Fluid of Premature Infants with Posthemorrhagic Hydrocephalus

Safety and Efficacy of Fasudil Monotherapy and Fasudil-Ozagrel Combination Therapy in Patients With Subarachnoid Hemorrhage: Sub-analysis of the Post-marketing Surveillance Study

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