Neuroimmune predictors of outcome after aneurysmal subarachnoid hemorrhage
- Authors: Ermakov SV1, Karpov SM2, Вaturin VA2, Belokon OS1, Mozheiko RA1,2
-
Affiliations:
- Stavropol Regional Clinical Hospital
- Stavropol State Medical University
- Issue: Vol 101, No 5 (2020)
- Pages: 754-759
- Section: Clinical experiences
- Submitted: 11.06.2020
- Accepted: 18.09.2020
- Published: 27.10.2020
- URL: https://kazanmedjournal.ru/kazanmedj/article/view/34735
- DOI: https://doi.org/10.17816/KMJ2020-754
- ID: 34735
Cite item
Abstract
Aim. To determine the possibility of predicting the course and outcomes of aneurysmal subarachnoid hemorrhage (aSAH) by using the detection of autoantibody level to neurospecific proteins.
Methods. The autoantibody level to neurospecific proteins was detected in 65 people: 30 healthy volunteers and 35 with a confirmed diagnosis of aneurysmal subarachnoid hemorrhage. Autoantibodies to myelin basic protein (MBP), peripheral myelin, dopamine receptors, myosin, N-methyl-D-aspartate (NMDA) receptors and S100 protein detected by using an enzyme immunoassay. The severity of illness in dynamics was defined in all patients by using the following scales: Rivermead mobility index, Hunt–Hess, Graeb and others. Statistical analysis was performed using Statistica 10.0, with the consistent use of descriptive statistics methods, the Mann–Whitney, Kruskal–Wallis and Pearson tests, Spearman coefficient.
Results. At the first stage, neurospecific proteins characterized by a large increase in autoantibody titers were identified. Further, based on the data obtained, a statistically significant correlation between autoantibody titers to S100 protein (360.43±40.35 µg/ml, p <0.05), MBP (145.91±12.43 µg/ml, p <0.05), NMDA receptors (66.17±6.42 µg/ml, p <0.05) and aSAH outcome was established.
Conclusion. The study revealed an increase in autoantibody level to neurospecific proteins in the blood plasma of patients, depending on the severity of subarachnoid hemorrhage and the development of delayed cerebral ischemia due to cerebral vasospasm; high antibodies titers to S100 protein in subarachnoid hemorrhage are associated with cerebral vasospasm and the development of secondary (delayed) ischemic changes in the brain.
Full Text
About the authors
S V Ermakov
Stavropol Regional Clinical Hospital
Author for correspondence.
Email: s.v.yermakov@yandex.ru
Russian Federation, Stavropol, Russia
S M Karpov
Stavropol State Medical University
Email: s.v.yermakov@yandex.ru
Russian Federation, Stavropol, Russia
V A Вaturin
Stavropol State Medical University
Email: s.v.yermakov@yandex.ru
Russian Federation, Stavropol, Russia
O S Belokon
Stavropol Regional Clinical Hospital
Email: s.v.yermakov@yandex.ru
Russian Federation, Stavropol, Russia
R A Mozheiko
Stavropol Regional Clinical Hospital; Stavropol State Medical University
Email: s.v.yermakov@yandex.ru
Russian Federation, Stavropol, Russia; Stavropol, Russia
References
- Golovina N.P., Lavrov U.V., Kutashov V.A., Sazonov J.E. Cerebral stroke: a modern view on the problem. Prikladnye informatsionnye aspekty meditsiny. 2015; 18 (5): 56–62. (In Russ.)
- Baturin V.A., Baturina M.V., Mamtseva G.I., Boev O.I. et al. Levels of neurotropic autoantibodies in patients with schizophrenia. Meditsinsky vestnik Severnogo Kavkaza. 2016; 11 (2): 176–178. (In Russ.) doi: 10.14300/mnnc.2016.11030.
- D’Souza S. Aneurysmal subarachnoid hemorrhage. Neurosurg. Anesth. 2015; 27 (3): 22–40. doi: 10.1097/ANA.0000000000000130.
- Kerz T., Boor S., Ulrich A. et al. Endovascular therapy for vasospasm after aneurysmatic subarachnoid hemorrhage. Brit. J. Neurosurg. 2016; 30 (5): 49–53. doi: 10.3109/02688697.2016.1173193.
- Becker K. Modulation of the postischemic immune response to improve stroke outcome. Stroke. 2010; 41: 75–78. doi: 10.1161/STROKEAHA.110.592881.
- Sanchez-Pena P., Pereira A.-R., Sourour N.-A. et al. S100B as an additional prognostic marker in subarachnoid aneurysmal hemorrhage. Crit. Care Med. 2008; 36 (8): 2267–2273. doi: 10.1097/CCM.0b013e3181809750.
- Belokon O.S., Ermakov S.V., Karpov S.M. et al. To the choice of surgical treatment of cerebral angiospasm in patients with aneurismatic subarachnoid hemorrhage. Meditsinskii vestnik Severnogo Kavkaza. 2020; 15 (1): 119–120. (In Russ.) doi: 10.14300/mnnc.2020.15028.
- Hop J.W., Rinkel G.J., Algra A. et al. Case-fatality rates and functional outcome after subarachnoid hemorrhage: A systematic re-view. Stroke. 1997; 28: 660–664. doi: 10.1161/01.str.28.3.660.
- Yong-Ke Zheng, Xiao-Qiao Dong, Quan Du. Comparison of plasma copeptin and multiple biomarkers for assessing prognosis of patients with aneurysmal subarachnoid hemorrhage. Clin. Chim. Acta. 2017; 465: 64–69. doi: 10.1016/j.cca.2017.10.009.
- Ayvazyan V.A., Boyadzhyan V.S., Manukyan L.A. et al. Komponenty sistemy komplementa C3 i factor B v krovi bol'nykh s ostrym ishemicheskim insul'tom. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. Prilozhenie Insul't. 2005; (15): 57–60. (In Russ.)
- Amantea D., Nappi G., Bernardi G. et al. Post-ischemic brain damage: pathophysiology and role of inflammatory mediators. FEBS J. 2009; 276 (1): 13–26. doi: 10.1111/j.1742-4658.2008.06766.x.