Systemic inflammation status at admission affects the outcome of intracerebral hemorrhage by increasing perihematomal edema but not the hematoma growth

Fonseca, Sónia; Costa, Francisca Pinho; Seabra, Mafalda; Dias, Rafael; Soares, Adriana; Dias, Celeste; Azevedo, Elsa; Castro, Pedro

doi:10.1007/s13760-019-01269-2

Cited by 34 publications

(53 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, depression at 3 months, an important comorbidity, may be related to higher NLR, suggesting that NLR may be a significant depression predictor. It is interesting to notice that NLR, as in IS, an immediate and intense systemic inflammatory response reduces the likelihood of a better functional outcome at 90 days, which is more likely to be explained by perihematomal edema growth than due to a significant hematoma expansion [ 29 ].…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Acute Inflammation in Cerebrovascular Disease: A Critical Reappraisal with Focus on Human Studies

Dias

Azevedo

et al. 2021

Life

Self Cite

View full text Add to dashboard Cite

Recent attention has been focused on the field of inflammatory biomarkers associated with vascular disorders, regarding diagnosis, prognosis, and possible therapeutical targets. In this study, we aimed to perform a comprehensive review of the literature regarding the use of inflammatory biomarkers in stroke patients. We searched studies that evaluated inflammation biomarkers associated with Cerebrovascular Disease (CVD), namely, ischemic Stroke (IS), Intracerebral Hemorrhage (ICH) and Cerebral Venous Thrombosis (CVT). As of today, neutrophil–lymphocyte ratio (NLR) seems the be the most widely studied and accepted biomarker for cerebrovascular disease due to its easy access and availability. Although demonstrated as a prognostic risk factor, in IS, ICH and CVT, its diagnostic role is still under investigation. Several other prognostic factors could be used or even combined together into a diagnostic or prognostic index. Multiple inflammatory biomarkers appear to be involved in IS, ICH, and CVT. Blood inflammatory cells, easily measured and accessible at admission may provide information regarding accurate diagnosis and prognosis. Although not yet a reality, increasing evidence exists to suggest that these may become potential therapeutic targets, likely influencing or mitigating complications of CVD and improving prognosis. Nevertheless, further larger, well-designed randomized clinical trials are still needed to follow up this hypothesis.

show abstract

Section: Resultsmentioning

confidence: 99%

“…One study of 135 patients with ICH showed that higher PLR was associated with independence at 90 days although this effect was not due to significant midline shift or hematoma expansion. Again, PLR was inferior to NLR in prognostic performance [ 29 ].…”

Section: Resultsmentioning

confidence: 99%

Acute Inflammation in Cerebrovascular Disease: A Critical Reappraisal with Focus on Human Studies

Dias

Azevedo

et al. 2021

Life

Self Cite

View full text Add to dashboard Cite

show abstract

“…We wanted to know if miR-7-5p is also associated with MMP-9, ZO-1, occludin, TNF-α, IL-6, NLR, and CRP and if it jointly affects brain edema. Studies have found that NLR may be related to the edema around the hematoma in patients with ICH (Gusdon et al, 2017;Fonseca et al, 2020). The baseline NLR can predict the occurrence and development of brain edema because a high NLR may result in neutrophil-induced neurotoxicity, increased capillary permeability, destruction of the BBB, and cell swelling (Zou et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

miR-7-5p Affects Brain Edema After Intracerebral Hemorrhage and Its Possible Mechanism

Chen

Deng

Qiang

et al. 2020

Front. Cell Dev. Biol.

View full text Add to dashboard Cite

Objective: To explore the relationship between miR-7-5p and brain edema after intracerebral hemorrhage and the role of butylphthalide (NBP) in brain edema after intracerebral hemorrhage.Method: Routine blood testing, C-reactive protein results, and computed tomography data were collected 1, 7, and 14 days after intracerebral hemorrhage in six patients. Levels of MMP-9, ZO-1, occludin, IL-6, TNF-α, and miR-7-5p were detected in each patient's serum. Sixty male Sprague–Dawley rats were randomly divided into sham operation, intracerebral hemorrhage, and NBP treatment groups. Dry–wet weight was used to assess brain edema, and Evans blue staining was used to assess the permeability of the blood–brain barrier. Expression levels of IL-6, TNF-α, ZO-1 and occludin, PI3K, AKT, p-AKT, AQP4, and miR-7-5p were analyzed in the rat brains.Result: The blood neutrophil–lymphocyte ratio (NLR) on day 1 was associated with the area of brain edema on day 7. The expression of miR-7-5p decreased after intracerebral hemorrhage, and as a result, the inhibition of the PI3K/AKT pathway was weakened. The decreased inhibition of the PI3K/AKT pathway resulted in an increase in AQP4 expression, which further aggravated brain edema. NBP can upregulate the expression of miR-7-5p, affecting these pathways to reduce brain edema.Conclusion: After intracerebral hemorrhage, miR-7-5p expression in brain tissue is reduced, which may increase the expression of AQP4 by activating the PI3K/AKT pathway. NBP can inhibit this process and reduce brain edema.

show abstract

“…Inflammatory status on admission was one of the contributing factors to an unfavorable outcome in sICH patients [6], as stroke is generally affecting systems such as cardiac, pulmonary, and immune system [7]. C-reactive protein (CRP), an acute phase inflammatory marker, has been associated with increased mortality [8][9][10], poor outcome [9] or hematoma volume [10] and growth [11].…”

Section: Background and Aimsmentioning

confidence: 99%

Feasibility of a pilot study on point-of-care biomarkers in spontaneous intracerebral hemorrhage in an emergency setting

Mureșan

Golea

Bolboacă

et al. 2021

Medicine and Pharmacy Reports

View full text Add to dashboard Cite

Background and aims. Stroke is a worldwide leading cause of death and disability and spontaneous intracerebral hemorrhage (sICH) has significant economic and social impact, regardless of recent efforts towards outcome-bettering acute interventions. The aim of the study was to assess the feasibility of a prospective observational research regarding point-of-care (POC) biomarkers in sICH, conducted in a level one emergency department (ED). Methods. Patients with acute (<8 hours) sICH were enrolled in this study. Patients presenting a Glasgow Coma Scale score <8, secondary causes of intracerebral hemorrhage, seizures, recent ischemic events, known thromboembolic disease, anticoagulant treatment, severe pre-stroke disability, terminal disease, scheduled neurosurgery/ hemostatic treatment were excluded. Feasibility was defined as ED inclusion and follow-up rates, time-to-inclusion, and frequency of missing data. Baseline demographic, imaging and POC biochemical status of the study group were documented, including inflammatory (complete blood count, C-reactive protein), metabolic (glucose, hepatic, and renal function) and cardiovascular markers (cardiac troponin I, D-dimer). Results. The inclusion rate was 2.16 patients/month with a final sample of 35 patients out of 239 potentially eligible patients. The median time from symptom onset to ED presentation was 128 minutes (IQR 96-239), with 21/35 patients having presented within the first 3 hours from ictus. Median times between symptoms’ onset to Computer Tomography (CT) scan and ED presentation to CT scan were 170 minutes (IQR 126-317) and 25 minutes (IQR 17-62), respectively. The median time from patient’s presentation to CBC result was 12 minutes (IQR 6.5-20), with 21/35 study participants having the results available within 15 minutes from ED arrival. The median cohort age was 72-years, with a 19/16 male/female ratio. Hypertension was the most frequent risk factor (77%), along with ischemic heart disease (31%) and diabetes (29%). One-third of the hypertensive patients did not undergo blood pressure lowering treatment. Median values of POC biomarkers on ED admission were within normal range. Conclusions. It was feasible to determine point-of-care biomarkers in spontaneous intracerebral hemorrhage on admission in ED, despite the urgency of the medical condition.

show abstract

Systemic inflammation status at admission affects the outcome of intracerebral hemorrhage by increasing perihematomal edema but not the hematoma growth

Cited by 34 publications

References 33 publications

Acute Inflammation in Cerebrovascular Disease: A Critical Reappraisal with Focus on Human Studies

Acute Inflammation in Cerebrovascular Disease: A Critical Reappraisal with Focus on Human Studies

miR-7-5p Affects Brain Edema After Intracerebral Hemorrhage and Its Possible Mechanism

Feasibility of a pilot study on point-of-care biomarkers in spontaneous intracerebral hemorrhage in an emergency setting

Contact Info

Product

Resources

About