Cerebrospinal fluid pentraxin 3 early after subarachnoid hemorrhage is associated with vasospasm

Elisa R. Zanier, Giovanna Brandi, Giuseppe Peri, Luca Longhi, Tommaso Zoerle, Mauro Tettamanti, Cecilia Garlanda, Anna Sigurtà, Serenella Valaperta, Alberto Mantovani, Maria Grazia De Simoni, Nino Stocchetti

Research output: Contribution to journalArticle

Abstract

Purpose: To investigate plasma and cerebrospinal fluid (CSF) concentrations of pentraxin 3 (PTX3), a prototypic long pentraxin protein induced by proinflammatory signals, in subarachnoid hemorrhage (SAH), and its relation with SAH-associated vasospasm. Methods: Serial plasma and CSF samples were collected from 38 consecutive SAH patients admitted to the Neurosurgical Intensive Care. PTX3 concentrations were analyzed in relation to clinical status and clinical vasospasm (defined as neuro-worsening and angiographic confirmation of vessel narrowing). Since neutrophils are an important source of preformed PTX3, myeloperoxidase (MPO) in CSF was measured to assess the correlation with CSF PTX3 and establish whether blood contamination was the determinant of PTX3 increase. Results: PTX3 was elevated in all SAH patients both in plasma and CSF. Acute peak (first 48 h after SAH) CSF PTX3 was significantly higher in patients who later developed vasospasm [median 13.6 (range 2.3-51.9) ng/ml] compared to those who did not [3.2 (0.1-50.5) ng/ml, p = 0.03]. The temporal pattern of CSF PTX3 in patients with vasospasm was triphasic with a peak during the first 48 h after SAH, a subsequent decrease in the following 48-96 h and a secondary significant increase with the occurrence of vasospasm. A loose correlation between CSF PTX3 and MPO was observed (r2 = 0.13), indicating that following SAH there is a brain production of PTX3. Conclusions: Acute increased concentrations of PTX3 in CSF but not in plasma are related to the occurrence of vasospasm, indicating that measurement of CSF PTX3 associated with the clinical evaluation can improve early diagnosis of this complication.

Original languageEnglish
Pages (from-to)302-309
Number of pages8
JournalIntensive Care Medicine
Volume37
Issue number2
DOIs
Publication statusPublished - Feb 2011

Fingerprint

Subarachnoid Hemorrhage
Cerebrospinal Fluid
Peroxidase
PTX3 protein
Critical Care
Early Diagnosis
Neutrophils

Keywords

  • Inflammation
  • Pentraxin 3
  • Subarachnoid hemorrhage
  • Vasospasm

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Cerebrospinal fluid pentraxin 3 early after subarachnoid hemorrhage is associated with vasospasm. / Zanier, Elisa R.; Brandi, Giovanna; Peri, Giuseppe; Longhi, Luca; Zoerle, Tommaso; Tettamanti, Mauro; Garlanda, Cecilia; Sigurtà, Anna; Valaperta, Serenella; Mantovani, Alberto; De Simoni, Maria Grazia; Stocchetti, Nino.

In: Intensive Care Medicine, Vol. 37, No. 2, 02.2011, p. 302-309.

Research output: Contribution to journalArticle

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abstract = "Purpose: To investigate plasma and cerebrospinal fluid (CSF) concentrations of pentraxin 3 (PTX3), a prototypic long pentraxin protein induced by proinflammatory signals, in subarachnoid hemorrhage (SAH), and its relation with SAH-associated vasospasm. Methods: Serial plasma and CSF samples were collected from 38 consecutive SAH patients admitted to the Neurosurgical Intensive Care. PTX3 concentrations were analyzed in relation to clinical status and clinical vasospasm (defined as neuro-worsening and angiographic confirmation of vessel narrowing). Since neutrophils are an important source of preformed PTX3, myeloperoxidase (MPO) in CSF was measured to assess the correlation with CSF PTX3 and establish whether blood contamination was the determinant of PTX3 increase. Results: PTX3 was elevated in all SAH patients both in plasma and CSF. Acute peak (first 48 h after SAH) CSF PTX3 was significantly higher in patients who later developed vasospasm [median 13.6 (range 2.3-51.9) ng/ml] compared to those who did not [3.2 (0.1-50.5) ng/ml, p = 0.03]. The temporal pattern of CSF PTX3 in patients with vasospasm was triphasic with a peak during the first 48 h after SAH, a subsequent decrease in the following 48-96 h and a secondary significant increase with the occurrence of vasospasm. A loose correlation between CSF PTX3 and MPO was observed (r2 = 0.13), indicating that following SAH there is a brain production of PTX3. Conclusions: Acute increased concentrations of PTX3 in CSF but not in plasma are related to the occurrence of vasospasm, indicating that measurement of CSF PTX3 associated with the clinical evaluation can improve early diagnosis of this complication.",
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AU - Zanier, Elisa R.

AU - Brandi, Giovanna

AU - Peri, Giuseppe

AU - Longhi, Luca

AU - Zoerle, Tommaso

AU - Tettamanti, Mauro

AU - Garlanda, Cecilia

AU - Sigurtà, Anna

AU - Valaperta, Serenella

AU - Mantovani, Alberto

AU - De Simoni, Maria Grazia

AU - Stocchetti, Nino

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AB - Purpose: To investigate plasma and cerebrospinal fluid (CSF) concentrations of pentraxin 3 (PTX3), a prototypic long pentraxin protein induced by proinflammatory signals, in subarachnoid hemorrhage (SAH), and its relation with SAH-associated vasospasm. Methods: Serial plasma and CSF samples were collected from 38 consecutive SAH patients admitted to the Neurosurgical Intensive Care. PTX3 concentrations were analyzed in relation to clinical status and clinical vasospasm (defined as neuro-worsening and angiographic confirmation of vessel narrowing). Since neutrophils are an important source of preformed PTX3, myeloperoxidase (MPO) in CSF was measured to assess the correlation with CSF PTX3 and establish whether blood contamination was the determinant of PTX3 increase. Results: PTX3 was elevated in all SAH patients both in plasma and CSF. Acute peak (first 48 h after SAH) CSF PTX3 was significantly higher in patients who later developed vasospasm [median 13.6 (range 2.3-51.9) ng/ml] compared to those who did not [3.2 (0.1-50.5) ng/ml, p = 0.03]. The temporal pattern of CSF PTX3 in patients with vasospasm was triphasic with a peak during the first 48 h after SAH, a subsequent decrease in the following 48-96 h and a secondary significant increase with the occurrence of vasospasm. A loose correlation between CSF PTX3 and MPO was observed (r2 = 0.13), indicating that following SAH there is a brain production of PTX3. Conclusions: Acute increased concentrations of PTX3 in CSF but not in plasma are related to the occurrence of vasospasm, indicating that measurement of CSF PTX3 associated with the clinical evaluation can improve early diagnosis of this complication.

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KW - Vasospasm

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