Evidence that a panel of neurodegeneration biomarkers predicts vasospasm, infarction, and outcome in aneurysmal subarachnoid hemorrhage.
Evidence that a panel of neurodegeneration biomarkers predicts vasospasm, infarction, and outcome in aneurysmal subarachnoid hemorrhage.
复制标题
DOI：
10.1371/journal.pone.0028938
复制
发表时间：
2011
期刊：
影响因子：
3.7
通讯作者：
Kumar MA
中科院分区：
文献类型：
--
作者：
Siman R;Giovannone N;Toraskar N;Frangos S;Stein SC;Levine JM;Kumar MA
神经退行性变的生物标志物可作为动脉瘤性蛛网膜下腔出血(ASAH)患者脑损伤和功能障碍的早期预后指标，具有临床和医学应用价值。最近，我们开发了一组新的神经退行性生物标记物，并在此报告了它们与严重ASAH后病理生理并发症和预后的关系。14名患者提供了长达10天的连续脑脊液样本，并通过超声、血管造影、磁共振成像和临床检查进行评估。在出院时和出院后6-9个月评估功能结果。8个急性脑损伤的生物标志物被量化：Calain衍生的α光谱蛋白N端和C端片段(CCSntf和CCSctf)，低磷化神经丝H，14-3-3β和ζ，泛素C末端水解酶L1，神经元特异性烯醇化酶，以及S100β。在一组患者中，所有8个生物标记物的水平都上升了100倍。比任何单一生物标志物更好的是，一组6个生物标志物与脑血管痉挛、脑梗塞和不良预后显著相关。此外，脑脊液中14-3-3β、CCSntf和NSE水平是随后中到重度血管痉挛的早期预测指标。这些数据提供了证据，表明一组神经退行性生物标记物可以预测持续的脑功能障碍以及导致ASAH后的病理生理过程。该小组可能是有价值的替代终点的受控临床评估的治疗干预措施和指导ASAH患者护理。
Biomarkers for neurodegeneration could be early prognostic measures of brain damage and dysfunction in aneurysmal subarachnoid hemorrhage (aSAH) with clinical and medical applications. Recently, we developed a new panel of neurodegeneration biomarkers, and report here on their relationships with pathophysiological complications and outcomes following severe aSAH. Fourteen patients provided serial cerebrospinal fluid samples for up to 10 days and were evaluated by ultrasonography, angiography, magnetic resonance imaging, and clinical examination. Functional outcomes were assessed at hospital discharge and 6–9 months thereafter. Eight biomarkers for acute brain damage were quantified: calpain-derived α-spectrin N- and C-terminal fragments (CCSntf and CCSctf), hypophosphorylated neurofilament H, 14-3-3 β and ζ, ubiquitin C-terminal hydrolase L1, neuron-specific enolase, and S100β. All 8 biomarkers rose up to 100-fold in a subset of patients. Better than any single biomarker, a set of 6 correlated significantly with cerebral vasospasm, brain infarction, and poor outcome. Furthermore, CSF levels of 14-3-3β, CCSntf, and NSE were early predictors of subsequent moderate-to-severe vasospasm. These data provide evidence that a panel of neurodegeneration biomarkers may predict lasting brain dysfunction and the pathophysiological processes that lead to it following aSAH. The panel may be valuable as surrogate endpoints for controlled clinical evaluation of treatment interventions and for guiding aSAH patient care.
登录
查看更多内容
影响因子：
5.1
作者：
Sehba, Fatima A.;Pluta, Ryszard M.;Zhang, John H.
通讯作者：
Zhang, John H.
影响因子：
4.2
作者：
Pineda, Jose A.;Lewis, Stephen B.;Hayes, Ronald L.
通讯作者：
Hayes, Ronald L.
影响因子：
4.8
作者：
Hoh, BL;Topcuoglu, MA;Ogilvy, CS
通讯作者：
Ogilvy, CS
影响因子：
2.5
作者：
Nylen, K.;Csajbok, L. Z.;Rosengren, L.
通讯作者：
Rosengren, L.
影响因子：
11
作者：
Petzold, A.;Keir, G.;Thompson, E. J.
通讯作者：
Thompson, E. J.