Artikel
Expression of Neuropeptide Y in CSF in patients with subarachnoid hemorrhage – related vasospasm
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Autoren
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Karl-Michael Schebesch
- Klinik für Neurochirurgie, Universität Regensburg, Deutschland
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Alexander Brawanski
- Klinik für Neurochirurgie, Universität Regensburg, Deutschland
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Simone Kagerbauer
- Klinik für Anästhesiologie, Technische Universität München, Deutschland
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Martin Proescholdt
- Klinik für Neurochirurgie, Universität Regensburg, Deutschland
| Veröffentlicht: | 16. September 2010 |
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Gliederung
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Objective: Among other function, the neurotransmitter polypeptide Neuropeptide Y (NPY) serves as a potent vasoconstrictor, physiologically. In the human brain, NPY is expressed in the hypothalamus, forebrain, hippocampus and brainstem and its role in the pathogenesis of SAH-related vasospasm has not been conclusively determined yet. In our series, we focused on the expression of NPY in CSF including 12 patients with and 11 patients without SAH-related vasospasm.
Methods: We evaluated a population of 23 patients with aneurysmal SAH (15 female, 8 male), mean age 53.9 yrs (range 34–80 yrs). In 12 patients, angiography and/or transcranial Doppler clearly revealed vasospasm. CSF was drawn daily from the ventricular tube and levels of NPY were determined on days 1, 4 and 10 after onset of SAH, utilizing a sandwich ELISA assay.
Results: Levels of NPY were significantly higher in patients with vasospasm compared to patients without vasospasm on day 1 (mean: 0.156±0.241 vs. 0.064±0.082 ng/ml, p<0.001); day 4 (mean: 0.216±0.245 vs. 0.043±0.044 ng/ml, p<0.001) and day 10 (mean: 0.141±0.182 vs. 0.020±0.040 ng/ml, p<0.001).
Conclusions: We could clearly show that the potent vasoconstrictor NPY is excessively expressed in CSF in patients with segmental vasoconstriction following SAH. As the time course (day 1 to 10) reveals, the neuronal re-uptake probably is inhibited. Our results justify the revival of research on NPY in patients suffering from aneurysmal SAH. NPY may play a major role in the multifactorial cascade of vasospasm due to aneurysmal SAH.
