CSF neutrophils are implicated in the development of vasospasm in subarachnoid hemorrhage.
CSF neutrophils are implicated in the development of vasospasm in subarachnoid hemorrhage.
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脑脊液中性粒细胞与蛛网膜下腔出血中血管痉挛的发生有关。
DOI：
10.1007/s12028-009-9308-7
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发表时间：
2010-04
影响因子：
3.5
通讯作者：
Ransohoff, R. M.
中科院分区：
文献类型：
--
作者：
Provencio, J. J.;Fu, X.;Siu, A.;Rasmussen, P. A.;Hazen, S. L.;Ransohoff, R. M.
脑血管痉挛是蛛网膜下腔出血（aSAH）后患者发病的重要原因。有效的治疗方法很少。寻找新的治疗方法主要集中在扩张脑血管上。越来越多的证据支持炎症在其发病机制中的作用，但尚未出现潜在的干预目标。收集aSAH患者的CSF和临床信息。此外，通过稳定同位素稀释HPLC和在线串联质谱法定量CSF样本中的酪氨酸修饰。我们报道了aSAH患者脑脊液中中性粒细胞积聚与血管痉挛的发生之间的关系。特别是，aSAH后第3天CSF中性粒细胞含量>62%是血管痉挛后期发展的独立预测因子（OR 6.8，95%CI 2.0-23.3，P = 0.002）。此外，髓过氧化物酶和NADPH氧化酶的活性在aSAH中升高，表明反应性氧化剂物质修饰CSF蛋白的作用。中性粒细胞百分比是aSAH患者血管痉挛的独立预测因子，在其发作前数天，提示中性粒细胞在血管痉挛中的作用。中性粒细胞酶的活性也增加，提示血管损伤的机制。中性粒细胞介导的炎症是血管痉挛治疗的潜在靶点。需要更多的研究来确定中性粒细胞损伤脑血管的机制。
Cerebral vasospasm is a significant cause of morbidity in patients after aneurysmal subarachnoid hemorrhage (aSAH). There are few effective treatments. The search for new treatments has focused predominantly on dilating cerebral blood vessels. Growing evidence supports a role for inflammation in its pathogenesis but no potential target for intervention has emerged. CSF and clinical information from patients with aSAH were collected. Additionally, tyrosine modifications by stable isotope dilution HPLC with online tandem mass spectrometry were quantified in CSF samples. We report an association between neutrophil accumulation in the cerebrospinal fluid of patients with aSAH and the development of vasospasm. In particular, CSF neutrophil content of >62% on the third day after aSAH is an independent predictor of the later development of vasospasm (OR 6.8, 95% CI 2.0–23.3, P = 0.002). Further, activity of myeloperoxidase and NADPH oxidase is elevated in aSAH suggesting a role for modification of CSF proteins by reactive oxidant species. Neutrophil percentage is an independent predictor of vasospasm in aSAH patients, days prior to its onset suggesting a role of neutrophils in vasospasm. The activity of neutrophil enzymes is also increased suggesting a mechanism for blood vessel damage. Inflammation mediated by neutrophils is a potential target for therapies in vasospasm. More study is necessary to determine the mechanism by which neutrophils damage cerebral blood vessels.
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