Cisternal CSF levels of cytokines after subarachnoid hemorrhage
Cisternal CSF levels of cytokines after subarachnoid hemorrhage
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DOI：
10.1080/01616412.1998.11740528
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发表时间：
1998-06-01
影响因子：
1.9
通讯作者：
De Benedetti, F
中科院分区：
文献类型：
--
作者：
Gaetani, P;Tartara, F;De Benedetti, F
细胞因子被认为是免疫和炎症反应的介质。在颅内动脉瘤手术患者中评价了脑池CSF中白细胞介素（IL）-6，IL-8，单核细胞趋化蛋白-1（MCP-1）和可溶性粘附分子E-选择素的水平。在手术时采集了41例选定患者的脑池CSF样本（31例诊断为蛛网膜下腔出血（SAH），10例对照患者因意外未破裂动脉瘤接受手术）; 14例患者在SAH后72小时内接受手术（早期手术），17例患者在出血后10天后接受手术（延迟手术）。使用放射免疫法评价CSF中细胞因子的水平，其浓度与手术时机、脑池蛛网膜下腔血凝块的量以及动脉血管痉挛的临床和血管造影证据的发作相关。在SAH后早期手术患者的样本中，平均脑池CSF中IL-6、IL-8和AMCP-1水平显著较高，而所有41例患者的E-选择素水平均低于该方法的阈值。在早期手术组中，7名患者出现症状性血管痉挛：与无并发症病例相比，IL-8和MCP-1水平无显著差异;另一方面，在SAH后72 h内手术并发生血管痉挛的患者亚组中，IL-ti水平显著较高。在接受延迟手术的患者中，5例出现症状性脑血管痉挛，但测量的脑池CSF细胞因子水平无显著差异。本研究的结果表明，在未破裂的动脉瘤患者中，细胞因子存在于脑池CSF中，数量稀少，并且在SAH后的蛛网膜下腔中，IL-6、IL-8和MCP-1显著增加。SAH后早期脑池CSF中IL-6水平升高可能对症状性脑血管痉挛的发生有一定的预测价值。
Cytokines are considered as mediators of immune and inflammatory responses. Cisternal CSF levels of interleukin (IL)-6, IL-8, monocyte chemoattractant protein-1 (MCP-1) and of the soluble adhesion molecule E-selectin were evaluated in patients operated on for intracranial aneurysms. Cisternal CSF samples were obtained at surgery in 41 selected patients (31 with diagnosis of subarachnoid hemorrhage (SAH) and 10 control patients operated on for incidental unruptured aneurysms); 14 patients were operated within 72 h after SAH (early surgery) and 17 were operated after day 10 after the hemorrhage (delayed surgery). The CSF levels of cytokines were evaluated using radioimmunoassay and their concentrations were related to the timing of surgery, the amount of cisternal subarachnoid blood clots and the onset of clinical and angiographical evidence of arterial vasospasm. Mean cisternal CSF levels of IL-6, IL-8 and AMCP-1 are significantly higher in samples obtained from patients early operated after SAH, while levels of E-selectin were below the threshold value of the method in all 41 cases. In the early operated group 7 patients presented symptomatic vasospasm: levels of IL-8 and MCP-1 were not significantly different when compared to those of uncomplicated cases; on the other hand, significantly higher levels of IL-ti were shown in the subgroup of patients operated within 72 h after SAH and developing vasospasm. Among the patients undergoing delayed surgery 5 presented symptomatic vasospasm, but no significant difference was shown in cisternal CSF levels of cytokines measured. The results of the present study show that in patients with unruptured aneurysms cytokines are present in cisternal CSF in scarce quantities and that in subarachnoid spaces after SAH there is an impressive increase of IL-6, IL-8 and MCP-1. Moreover, the higher cisternal CSF levels of IL-6 found in the early stage after SAH might have a predictive value regarding the occurrence of symptomatic vasospasm.