Peripheral Blood Occludin Level as a Biomarker for Perioperative Cerebral Edema in Patients with Brain Tumors

Abstract

Objective. Cerebral edema is a common complication of brain tumors in the perioperative period. However, there is currently no reliable and convenient method to evaluate the extent of brain edema. The objective is to explore the effectiveness of serum occludin on predicting the extent of perioperative brain edema and outcome in patients with brain tumors. Methods. This prospective study enrolled 55 patients with brain tumors and 24 healthy controls in Sanbo Brain Hospital from June 2019 through November 2019. Serum occludin levels were measured preoperatively and on postoperative day 1. Peritumoral edema was assessed preoperatively using MRI. Pericavity brain edema on postoperative day 1 was evaluated using CT. Results. Compared with healthy controls, the serum occludin level was higher in patients with brain tumors both preoperatively and postoperatively (P<0.001). The serum occludin level correlated positively with the degree of brain edema preoperatively (r=0.78, P<0.001) and postoperatively (r=0.59, P<0.001). At an optimal cutoff of 3.015 ng/mL, the preoperative serum occludin level discriminated between mild and severe preoperative brain edema with a sensitivity of 90.48% and specificity of 84.62%. At an optimal cutoff value of 3.033 ng/mL, the postoperative serum occludin level distinguished between mild and severe postoperative brain edema with a sensitivity of 97.30% and specificity of 55.56%. Conclusions. The serum occludin level is associated with cerebral edema and could potentially be used as a biomarker for perioperative cerebral edema. This trial is registered with ChiCTR1900023742.

Occludin facilitates tumour angiogenesis in bladder cancer by regulating IL8/STAT3 through STAT4

“…10 In addition, OCLN levels in the peripheral blood have been used as a tumorigenic biomarker of cerebral oedema caused by blood-brain barrier (BBB) damage in patients with brain tumors. 11 Other tight junction proteins, such as tight junction protein 1 (TJP1) and Claudin-5, have been indicated to regulate vascular abnormalities during tumour progression. [12][13][14] A few studies have also shown roles of OCLN in modulating tumour angiogenesis and tube-forming activity for tumour invasion.…”

“…In lung cancer, downregulation of OCLN inhibits activation of the AKT/PI3K signalling pathway and cell proliferation, thus increasing tumour apoptosis in vitro and in vivo 10 . In addition, OCLN levels in the peripheral blood have been used as a tumorigenic biomarker of cerebral oedema caused by blood‐brain barrier (BBB) damage in patients with brain tumors 11 . Other tight junction proteins, such as tight junction protein 1 (TJP1) and Claudin‐5, have been indicated to regulate vascular abnormalities during tumour progression 12–14 .…”

Edaravone Dexborneol Downregulates Neutrophil Extracellular Trap Expression and Ameliorates Blood-Brain Barrier Permeability in Acute Ischemic Stroke

“…MPO-DNA complex and citrullinated H3 (citH3) are markers of NETs. MPO-DNA complex (cell death detection ELISA kit, Roche), citH3 (Cayman Chemical, USA), and serum occludin (USCN, China) were tested by capture ELISA based on previous studies and manufacturer's instructions [ 17 , 18 ].…”

Blood-Brain Barrier Alterations and Edema Formation in Different Brain Mass Lesions

“…Upregulation of claudin-5 and occludin is also seen upon glucocorticoid administration, a commonly used therapy to alleviate peritumoral edema in patients with GBM (Na et al, 2017). Interestingly, downregulation of plasma occludin levels has been shown to correlate with peritumoral brain edema volume and severity, suggesting that it may be used as a potential peritumoral edema biomarker (Park et al, 2006;Shi et al, 2020).…”