Document Detail

Alpha-II spectrin breakdown products in aneurysmal subarachnoid hemorrhage: a novel biomarker of proteolytic injury.
MedLine Citation:
PMID:  17937225     Owner:  NLM     Status:  MEDLINE    
OBJECT: Aneurysmal subarachnoid hemorrhage (ASAH) is a serious event with grave consequences. Delayed ischemic neurological deficits caused by cerebral arterial vasospasm contribute significantly to death and disability. Biomarkers may reflect brain injury and provide an early warning of impending neurological decline and stroke from ASAH-induced vasospasm. Alpha-II spectrin is a cytoskeletal protein whose breakdown products are candidate surrogate markers of injury magnitude, treatment efficacy, and outcome. In addition, all spectrin breakdown products (SBDPs) can provide information on the proteolytic mechanisms of injury. METHODS: Twenty patients who received a diagnosis of Fisher Grade 3 ASAH were enrolled in this study to examine the clinical utility of SBDPs in the detection of cerebral vasospasm in patients with ASAH. All patients underwent placement of a ventriculostomy for continual cerebrospinal fluid drainage within 72 hours of ASAH onset. Cerebrospinal fluid samples were collected every 6 hours and analyzed using Western Blotting for SBDPs. Onset of vasospasm was defined as an acute onset of a focal neurological deficit or a change in Glasgow Coma Scale score of two or more points. All suspected cases of vasospasm were confirmed on imaging studies. RESULTS: Both calpain- and caspase-mediated SBDP levels are significantly increased in patients suffering ASAH. The concentration of SBDPs was found to increase significantly over baseline level up to 12 hours before the onset of cerebral arterial vasospasm. CONCLUSIONS: Differential expression of SBDPs suggests oncotic necrotic proteolysis may be predominant in acute brain injury after ASAH and cerebral arterial vasospasm.
Stephen B Lewis; Gregory J Velat; Lynn Miralia; Linda Papa; Jada M Aikman; Regina A Wolper; Chris S Firment; Ming Chen Liu; Jose A Pineda; Kevin K W Wang; Ronald L Hayes
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  107     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-10-16     Completed Date:  2007-11-07     Revised Date:  2007-12-03    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  792-6     Citation Subset:  AIM; IM    
Department of Neurological Surgery, University of Florida, Gainesville 32610, USA.
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MeSH Terms
Angiography, Digital Subtraction
Biological Markers / cerebrospinal fluid*
Calpain / metabolism
Caspases / metabolism
Cerebral Angiography
Middle Aged
Spectrin / cerebrospinal fluid*,  metabolism
Subarachnoid Hemorrhage / cerebrospinal fluid*,  pathology*,  radiography
Tomography, X-Ray Computed
Vasospasm, Intracranial / cerebrospinal fluid,  pathology,  radiography
Grant Support
Reg. No./Substance:
0/Biological Markers; 12634-43-4/Spectrin; EC 3.4.22.-/Calpain; EC 3.4.22.-/Caspases

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