High CSF transforming growth factor β levels after subarachnoid haemorrhage: association with chronic communicating hydrocephalus
High CSF transforming growth factor β levels after subarachnoid haemorrhage: association with chronic communicating hydrocephalus
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DOI：
10.1136/jnnp.2008.155671
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发表时间：
2009-05-01
影响因子：
11
通讯作者：
Logan, A.
中科院分区：
文献类型：
--
作者：
Douglas, M. R.;Daniel, M.;Logan, A.
背景资料：慢性交通性脑积水是蛛网膜下腔出血的常见后遗症，当蛛网膜下腔纤维化后CSF的流动和引流受损时发生。转化生长因子（TGF）β 1/β 2在蛛网膜下腔出血后由血小板释放到CSF中，是可能促进出血后纤维化和慢性交通性脑积水的强效纤维化因子。方法：总的时间变化（潜伏加活性）TGF β 1/β 2 CSF水平，使用ELISA测量发生急性脑积水的出血患者以发现在随后发生慢性交通性脑积水的患者中滴度是否更高，结果：对照组（非出血性）脑积水患者CSF中TGF β 1和TGF β 2的平均水平分别为97（42）pg/ml和395（39）pg/ml。在蛛网膜下腔出血（dph）后1-5天，观察到总TGF β 1和TGF β 2的水平分别为1427（242）pg/ml和976（191）pg/ml。超过5 dph，总TGF β 1/β 2水平下降，但仍显著升高（p < 0.01），高于对照患者值至少19 dph。出血患者发展为慢性交通性脑积水，其总TGF β 1水平显著升高，（p，0.01）和TGF β 2（p < 0.05），与出血患者相比，没有。结论：TGFb 1/TGF β 1的急性测量水平因此，蛛网膜下腔出血患者CSF中的b2是随后发展为慢性交通性脑积水的潜在预后生物标志物，表明可能依赖于CSF分流。
Background: Chronic communicating hydrocephalus is a common sequela of subarachnoid haemorrhage and develops when the flow and drainage of CSF are impaired after fibrosis in the subarachnoid space. Released by platelets into the CSF after subarachnoid haemorrhage, transforming growth factor (TGF) beta 1/beta 2 are potent fibrogenic agents that may promote post-haemorrhagic fibrosis and chronic communicating hydrocephalus.Methods: Temporal changes in total (latent plus active) TGF beta 1/beta 2 CSF levels of post-haemorrhage patients developing acute hydrocephalus were measured using ELISA to discover if titres were higher in patients that subsequently developed chronic communicating hydrocephalus, compared with those that did not.Results: Mean (SD) CSF levels of total TGFb1 were 97 (42) pg/ml and total TGF beta 2 were 395 (39) pg/ml in control patients with (non-haemorrhagic) hydrocephalus. For days 1-5 post-subarachnoid haemorrhage (dph), levels of 1427 (242) pg/ml and 976 (191) pg/ml were seen for total TGFb1 and TGF beta 2, respectively. Beyond 5 dph, total TGFb1/b2 levels declined but remained significantly elevated (p < 0.01) above control patient values for at least 19 dph. Haemorrhagic patients that went on to develop chronic communicating hydrocephalus had significantly higher levels of total TGFb1 (p, 0.01) and TGF beta 2 (p < 0.05) between 1 and 9 dph, compared with those of haemorrhagic patients that did not.Conclusions: Acutely measured levels of TGFb1/b2 in the CSF of patients with subarachnoid haemorrhage are thus potential prognostic biomarkers for the subsequent development of chronic communicating hydrocephalus, indicating likely dependency on CSF shunting.