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55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

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Activation of cerebral Endothelin-system after subarachnoid hemorrhage is reflected by the C-terminal fragment in cerebrospinal fluid

Die Aktivierung des zerebralen Endothelin-Systems nach Subarachnoidalblutung ist durch Messung des C-terminalen Fragmentes im Liquor nachvollziehbar

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  • corresponding author Hartmut Vatter - Klinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität, Frankfurt/Main
  • M. Zimmermann - Klinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität, Frankfurt/Main
  • V. Seifert - Klinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität, Frankfurt/Main
  • L. Schilling - Abteilung für Neurochirurgische Forschung, Fakultät für Klinische Medizin Mannheim der Universität Heidelberg, Mannheim

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocMO.10.07

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2004/04dgnc0104.shtml

Published: April 23, 2004

© 2004 Vatter et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective

Enhanced synthesis of Endothelin (ET)-1 is considered a key factor in the development of cerebral vasospasm (CVS) after subarachnoid hemorrhage (SAH). Stimulation of the activity of the cerebral ET-system has previously been concluded from an increased ET-1 content in cerebrospinal fluid (CSF) of patients suffering from SAH. However, these measurements did not reveal vasoacitve concentrations. In the present investigation we compared the concentrations of ET-1 and its vasoinactive companion peptide C-terminal fragment (CTF) to evaluate its prognostic value on the development of CVS.

Methods

Samples of CSF and plasma were obtained from 5 patients suffering from SAH (Hunt and Hess °IV) and developing delayed CVS as proven by angiography. The concentrations of ET-1 and CTF were analyzed by radioimmuno assay (RIA) in samples covering up to day 7 after bleeding.

Results

Plasma concentration of CTF was 3.5±0.8 (mean±SEM)-fold higher than ET-1 but without a correlation with the development of CVS. In contrast, ET-1 and CTF concentrations in CSF steadily increased after SAH. This increase was markedly more pronounced for CTF than for ET-1. Accordingly, the difference of the basal level to the maximum value was 83 ± 39 pg/ml for ET-1 and 154 ± 49 pg/ml for CTF. A significantly higher concentration of CTF versus ET-1 in CSF occurred from 3 day on. An increase of CTF concentration apparently preceded development of vasospasm.

Conclusions

Given an equimolar generation of ET-1 and CTF, concentration of CTF in CSF appears to reflect activation of the cerebral ET-system more precisely than ET-1. Maximum CSF concentrations of CTF are clearly in the range in which ET-1 exerts vasoconstriction. Thus, the present study suggests that the CTF level in CSF as a prognostic factor for development of CVS is superior compared to ET-1.