gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

Systemic HMGB1, a novel predictive biomarker for cerebral vasospasm in patients with aneurysmal subarachnoid hemorrhage

Meeting Abstract

  • Sajjad Muhammad - Bonn, Deutschland
  • Shafqat Rasul Chaudhry - Bonn, Deutschland
  • Agi Güresir - Bonn, Deutschland
  • Birgit Stoffel Wagner - Bonn, Deutschland
  • Hartmut Vatter - Bonn, Deutschland
  • Erdem Güresir - Bonn, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocMi.11.08

doi: 10.3205/17dgnc435, urn:nbn:de:0183-17dgnc4356

Published: June 9, 2017

© 2017 Muhammad et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objective: HMGB1 is a non-histone DNA binding nuclear protein expressed in almost all eukaryotic cells. Translocation of HMGB1 out of the nucleus up-regulates inflammatory response in different diseases including subarachnoid hemorrhage. Pro-inflammatory molecules have been suggested to play an important role during early brain injury and cerebral vasospasm (CVS) after subarachnoid hemorrhage. Systemic release of HMGB1 after SAH and its association with development of CVS has not yet been investigated in detail. This study was aimed to investigate the release of HMGB1 in serum of patients after subarachnoid hemorrhage and its association with cerebral vasospasm.

Methods: We enrolled 53 patients with Hunt and Hess grade I-V that were admitted to our hospital between 2012 and 2015. The peripheral venous blood was withdrawn on days 1,3,5,7,9,11, and on day 13 from SAH patients, whereas once from the controls. The blood was centrifuged to obtain the serum that was immediately frozen at -80 °C. HMGB1 was quantified with standard ELISA. Plasma IL-6 and peripheral blood leukocytes were also determined over the first 2 weeks after SAH. Patients’ data and post hemorrhagic complication were recorded prospectively.

Results: HMGB1 was significantly elevated in plasma of patients after SAH from day 1 to day 13 as compared to non-SAH patients. Patients with CVS (n=31) showed significantly higher HMGB1 starting from day1 till day 13 as compared to patients without CVS (n=22). HMGB1 serum concentration in patients treated with endovascular coiling did not differ from patients who underwent surgical clipping excluding the effect of craniotomy on HMGB1 elevation. Furthermore, systemic infection did not influence HMGB1 levels significantly. Cumulative levels of HMGB1 showed significant correlation with peripheral blood leukocytes and IL-6 levels (p<0.05). ROC curves showed that serum HMGB1levels on admission is a fair predictive biomarker for CVS with sensitivity of 77 % and specificity of 59 % at a cutoff value of 5.5 ng/ ml.

Conclusion: Serum HMGB1 is differentially elevated after SAH. Serum HMGB1 levels were elevated early after SAH and were significantly high until day 13 in patients who developed CVS. Our data suggests that serum HMGB1 is a predictive biomarker for the detection of CVS with a fair sensitivity and specificity