Document Detail


CSF neutrophils are implicated in the development of vasospasm in subarachnoid hemorrhage.
MedLine Citation:
PMID:  19967568     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cerebral vasospasm is a significant cause of morbidity in patients after aneurysmal subarachnoid hemorrhage (aSAH). There are few effective treatments. The search for new treatments has focused predominantly on dilating cerebral blood vessels. Growing evidence supports a role for inflammation in its pathogenesis but no potential target for intervention has emerged.
METHODS: CSF and clinical information from patients with aSAH were collected. Additionally, tyrosine modifications by stable isotope dilution HPLC with online tandem mass spectrometry were quantified in CSF samples.
RESULTS: We report an association between neutrophil accumulation in the cerebrospinal fluid of patients with aSAH and the development of vasospasm. In particular, CSF neutrophil content of >62% on the third day after aSAH is an independent predictor of the later development of vasospasm (OR 6.8, 95% CI 2.0-23.3, P = 0.002). Further, activity of myeloperoxidase and NADPH oxidase is elevated in aSAH suggesting a role for modification of CSF proteins by reactive oxidant species.
CONCLUSIONS: Neutrophil percentage is an independent predictor of vasospasm in aSAH patients, days prior to its onset suggesting a role of neutrophils in vasospasm. The activity of neutrophil enzymes is also increased suggesting a mechanism for blood vessel damage. Inflammation mediated by neutrophils is a potential target for therapies in vasospasm. More study is necessary to determine the mechanism by which neutrophils damage cerebral blood vessels.
Authors:
J J Provencio; X Fu; A Siu; P A Rasmussen; S L Hazen; R M Ransohoff
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Neurocritical care     Volume:  12     ISSN:  1556-0961     ISO Abbreviation:  Neurocrit Care     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-23     Completed Date:  2010-06-23     Revised Date:  2011-07-27    
Medline Journal Info:
Nlm Unique ID:  101156086     Medline TA:  Neurocrit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  244-51     Citation Subset:  IM    
Affiliation:
NB3, Neuroinflammation Research Center, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, USA. provenj@ccf.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Female
Humans
Male
Middle Aged
Neutrophils / metabolism*
Reactive Oxygen Species / cerebrospinal fluid
Subarachnoid Hemorrhage / cerebrospinal fluid*,  complications,  physiopathology*
Tandem Mass Spectrometry
Tyrosine / analogs & derivatives,  cerebrospinal fluid
Vasospasm, Intracranial / cerebrospinal fluid*,  complications
Grant Support
ID/Acronym/Agency:
K08 NS051350/NS/NINDS NIH HHS; K08 NS051350-03/NS/NINDS NIH HHS; K24 NS51400/NS/NINDS NIH HHS; P01HL076491/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Reactive Oxygen Species; 0/bromotyrosine; 55520-40-6/Tyrosine; 7298-90-0/3-chlorotyrosine
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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