Serum caspase-cleaved cytokeratin-18 levels and outcomes after aneurysmal subarachnoid hemorrhage

Yuan, Zi-Gang; Wang, Jianli; Jin, Guo-Liang; Yu, Xin; Jin-quan, LI; Qiu, Tianlun; Dai, Rongxiao

doi:10.1016/j.jns.2015.11.020

Cited by 14 publications

(13 citation statements)

References 27 publications

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“…However, the association between high serum CCCK-18 levels and MMCAI patients mortality found in our study is a novel finding. Those findings are in consonance with those of previous studies, due to that there is be found an association between high serum CCCK-18 levels and poor prognosis of patients with traumatic brain injury [ 28 ], acute spontaneous intracerebral haemorrhage [ 29 ] and aneurysmal subarachnoid hemorrhage [ 30 ].…”

Section: Discussionsupporting

confidence: 92%

“…Cytokeratin-18 exists mainly in the intracytoplasmic cytoskeleton of epithelial tissue and during apoptosis citokeratin-18 is cleaved by caspases and appears as CCCK-18 into the blood [ 14 , 15 ]. Then the question about the origen of CCCK-18 in patients with traumatic brain injury [ 28 ], spontaneous cerebral hemorrhage [ 29 , 30 ], and cerebral infarction (our current study) arise now. There is two posible splanations for that question.…”

Section: Discussionmentioning

confidence: 99%

“…Previously, there were found higher circulating CCCK-18 levels in patients with sepsis [ 16 – 20 ], liver diseases [ 21 – 25 ], and tumoral diseases [ 26 , 27 ]. In addition, there was found an association between high circulating CCCK-18 levels and a poor prognosis of patients with different cerebral process, such as traumatic brain injury [ 28 ] and spontaneous cerebral hemorrhage [ 29 , 30 ]. However, they have not been explored in patients with ischemic stroke.…”

Section: Introductionmentioning

confidence: 99%

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High serum levels of caspase-cleaved cytokeratin-18 are associated with malignant middle cerebral artery infarction patient mortality

et al. 2018

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BackgroundThere have been found apoptotic changes in brain tissue samples from humans after cerebral ischemia. Caspase-cleaved cytokeratin (CCCK)-18 could appears in blood during apoptosis. High circulating levels of CCCK-18 have been associated with a poor prognosis in patients with cerebral process, such as traumatic brain injury and spontaneous cerebral hemorrhage. However, they have not been explored in patients with ischemic stroke. Thus, the aim of this study was to determine whether there is an association between serum CCCK-18 levels and mortality in patients with severe malignant middle cerebral artery infarction (MMCAI).MethodsThis was an observational, prospective and multicentre study. We included patients with severe MMCAI. We considered MMCAI as severe when Glasgow Coma Scale (GCS) was lower than 9. We measured serum CCCK-18 levels at the diagnosis moment of the severe MMCAI.ResultsWe found that non-surviving severe MMCAI patients (n = 33) showed lower GCS and platelet count, and higher serum CCCK-18 levels than survivor ones (n = 33). We found an area under the curve (AUC) of serum CCCK-18 levels to predict 30-day mortality of 82% (95% CI = 71%–91%; p < 0.001). In the multiple logistic regression analysis was found that serum CCCK-18 levels were associated with 30-day mortality (OR = 1.023; 95% CI = 1.010–1.037; p = 0.001) after to control for platelet count and GCS.ConclusionsTo our knowledge, this is the first series reporting data on serum CCCK-18 levels in ischemic stroke patients. The novel findings of our study were that non-surviving severe MMCAI patients had higher serum CCCK-18 levels than surviving patients, and that there is an association between high serum CCCK-18 levels and MMCAI patients mortality.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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High serum levels of caspase-cleaved cytokeratin-18 are associated with malignant middle cerebral artery infarction patient mortality

et al. 2018

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“…has shown that serum levels of CCCK-18 are associated with mortality in patients with severe TBI. [ 199 ] Two recent studies have also demonstrated that blood levels of CCCK-18 were increased in patients with intracerebral hemorrhage[ 190 ] and aneurysmal SAH,[ 193 ] and the increased levels were associated with poor short- and long-term neurological outcomes and mortality. A study by Gu et al .…”

Section: Caspase-cleaved Products As Biomarkers Of Brain Apoptosis Fomentioning

confidence: 99%

Prospective clinical biomarkers of caspase-mediated apoptosis associated with neuronal and neurovascular damage following stroke and other severe brain injuries: Implications for chronic neurodegeneration

Glushakova

Glushakov²,

Wijesinghe

et al. 2017

Brain Circ

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“…Higher circulating levels of CCCK-18 have been found in non-surviving compared to surviving patients suffering from traumatic brain injury [17] or spontaneous cerebral haemorrhage [18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Non-Survivor Ischemic Stroke Patients Maintain High Serum Caspase-Cleaved Cytokeratin-18 Levels

et al. 2020

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Objective: Caspase-cleaved cytokeratin (CCCK)-18 could appear in blood during apoptosis. In two different studies, on day 1 of cerebral infarction and at 72 h of cerebral infarction, respectively, higher circulating CCCK-18 levels were found in non-surviving than in surviving patients. The objective of this study was to analyze the ability of these levels to predict mortality at any time during the first week of cerebral infarction. Methods: Patients with malignant middle cerebral artery infarction (MMCAI) were included and the diagnosis criteria were the presence, observed in a computed tomography, of an acute cerebral infarction in at least 50% of this territory and midline shift, and an acute neurological deterioration with a Glasgow Coma Scale ≤ 8. Serum CCCK-18 levels at days 1, 4 and 8 of MMCAI were determined. Results: Serum concentrations of CCCK-18 at days 1, 4 and 8 of MMCAI were higher in non-surviving (n = 34) than in surviving patients (n = 34). Serum CCCK-18 concentrations at days 1, 4 and 8 of MMCAI had an area under curve (95% CI) used to predict a 30-day mortality of 0.83 (0.72 –0.91; p < 0.001), 0.78 (0.65–0.89; p < 0.001) and 0.82 (0.68–0.92; p < 0.001). Conclusions: The novel finding is that serum levels of CCCK-18 levels at any time after the first week of MMCAI could help predict 30-day mortality.

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Serum caspase-cleaved cytokeratin-18 levels and outcomes after aneurysmal subarachnoid hemorrhage

Cited by 14 publications

References 27 publications

High serum levels of caspase-cleaved cytokeratin-18 are associated with malignant middle cerebral artery infarction patient mortality

High serum levels of caspase-cleaved cytokeratin-18 are associated with malignant middle cerebral artery infarction patient mortality

Prospective clinical biomarkers of caspase-mediated apoptosis associated with neuronal and neurovascular damage following stroke and other severe brain injuries: Implications for chronic neurodegeneration

Non-Survivor Ischemic Stroke Patients Maintain High Serum Caspase-Cleaved Cytokeratin-18 Levels

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