Soluble Endoglin and Transforming Growth Factor-β1 and the Development of Vasospasm after Spontaneous Subarachnoid Hemorrhage: A Pilot Study
Soluble Endoglin and Transforming Growth Factor-β1 and the Development of Vasospasm after Spontaneous Subarachnoid Hemorrhage: A Pilot Study
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DOI：
10.1159/000331925
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发表时间：
2012-01-01
影响因子：
2.9
通讯作者：
Beer, Ronny
中科院分区：
文献类型：
--
作者：
Dietmann, Anelia;Lackner, Peter;Beer, Ronny
背景资料：脑血管痉挛（CVS）和血管痉挛引起的脑梗死（CIV）是自发性蛛网膜下腔出血（SAH）的主要并发症。血管紧张素的改变被认为是CVS发病机制中的一个重要因素。转化生长因子-β（TGF-β）家族的成员及其受体已涉及血管张力的调节。研究方法：采用ELISA法分析20例SAH患者SAH后15天内血清可溶性内皮素（sEng）和血浆TGF-β 1水平，并与CVS、CIV和预后相关。20名年龄和性别匹配的自愿献血者作为健康对照（HC）。结果：SAH患者血清sEng水平显著低于HC患者，而血浆TGF-β 1水平显著高于HC患者。发生多普勒超声CVS（dCVS）的患者TGF-β（1）水平显著升高。CIV患者和脑积水患者的sEng水平显著降低。在第3天，pSAH sEng水平低于3.88 ng/ml或TGF-β 1水平高于7.2 ng/ml对CIV的发展具有预测价值。研究期间sEng平均水平低高度预测SAH后6个月的长期功能结局差（改良兰金量表>= 2）。结论：与HC相比，SAH患者血清中血管活性因子sEng和血浆中TGF-β 1的浓度显著改变。这项初步研究的结果表明，sEng可以代表SAH后继发性并发症和长期功能结局发生的新预后生物标志物。版权所有（c）2011 S. Karger AG，巴塞尔
Background: Cerebral vasospasm (CVS) and cerebral infarction due to vasospasm (CIV) are major complications after spontaneous subarachnoid hemorrhage (SAH). Alteration of vasomotor tone has been postulated as an important factor in the pathogenesis of CVS. Members of the transforming growth factor-beta (TGF-beta) family and their receptors have been implicated in the regulation of vascular tone. Methods: Serum levels of soluble endoglin (sEng) and plasma levels of TGF-beta(1) of 20 consecutive SAH patients were analyzed within 15 days after SAH using ELISA and correlated with CVS, CIV and outcome. Twenty voluntary age- and sex-matched blood donors served as healthy controls (HCs). Results: SAH patients showed significantly lower sEng serum levels and higher TGF-beta(1) plasma levels compared to HCs. Patients who developed Doppler sonographic CVS (dCVS) had significantly higher TGF-beta(1) levels. Patients with CIV and patients with hydrocephalus showed significantly lower sEng levels. On day 3, pSAH sEng levels below 3.88 ng/ml or TGF-beta(1) levels higher than 7.2 ng/ml had a predictive value for the development of CIV. Low mean sEng levels over the study period were highly predictive of poor long-term functional outcome (modified Rankin Scale >= 2) at 6 months after SAH. Conclusions: Concentrations of the vasoactive factors sEng in serum and TGF-beta(1) in plasma are significantly altered in SAH patients compared to HCs. The results of this pilot study indicate that sEng could represent a novel prognostic biomarker for the onset of secondary complications and long-term functional outcome after SAH. Copyright (c) 2011 S. Karger AG, Basel