gms | German Medical Science

70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

A prospective microarray screening of systemic and cerebral inflammatory biomarkers for prediction and confirmation of delayed cerebral ischemia (DCI) after aneurysmal subarachnoid haemorrhage (aSAH)

Eine prospektives Mikroarray-Screening von systemischen und inflammatorischen Biomarkern für die Prädiktion und Konfirmation von verzögerter zerebraler Ischämie nach aneurysmatischer Subarachnoidalblutung

Meeting Abstract

  • presenting/speaker Walid Albanna - RWTH Aachen, Klinik für Neurochirurgie, Aachen, Deutschland
  • Miriam Weiss - RWTH Aachen, Klinik für Neurochirurgie, Aachen, Deutschland
  • Catharina Conzen - RWTH Aachen, Klinik für Neurochirurgie, Aachen, Deutschland
  • Lars Ove Brandenburg - RWTH Aachen, Institut für Anatomie und Zellbiologie, Aachen, Deutschland
  • Christian Blume - RWTH Aachen, Klinik für Neurochirurgie, Aachen, Deutschland
  • Hans Clusmann - RWTH Aachen, Klinik für Neurochirurgie, Aachen, Deutschland
  • Christian Stoppe - RWTH Aachen, Klinik für Operative Intensivmedizin und Intermediate Care, Aachen, Deutschland
  • Gerrit Alexander Schubert - RWTH Aachen, Klinik für Neurochirurgie, Aachen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocV215

doi: 10.3205/19dgnc232, urn:nbn:de:0183-19dgnc2328

Published: May 8, 2019

© 2019 Albanna 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: Delayed cerebral ischemia (DCI) is commonly observed after aSAH and may result in extensive neurological injury. Inflammatory cascades and disturbances of platelet aggregation are thought to contribute to DCI, but validation and broad testing of more extensive sets of potentially predictive biomarkers addressing specific pathophysiological cascades is both labor- and cost-intensive. Using the inflammatory cascade as an exemplary scenario, this study was designed to identify potentially predictive or confirmative biomarkers preceding DCI in serum, CSF and cerebral microdialysate (MD) via prospective microarray screening, followed by confirmatory analysis of MIF (U-Plex Assay).

Methods: Four consecutive patients (mean age 66.8±21) with aSAH were prospectively included in the screening-procedure using Microarray (RayBio®). Two patients developed DCI, while two patients with an uncomplicated clinical course served as controls. Samples of serum, CSF, and MD were collected from each patient in the early (days 1-3) and critical phase (days 7-9), amounting to 24 samples. The relative differences in expression levels of each marker were calculated between groups (DCId1-3 vs noDCId1-3, DCId7-9 vs noDCId7-9). Subsequently, a total of 30 additional consecutive patients (mean age 57.9±12) were prospectively enrolled for exemplary confirmation of previous trends (MIF) using U-Plex Assay. Samples were collected from each patient in the early (EPd1-3) and critical phase (CPd5-9).

Results: 506 biomarkers were screened. Out of 200 inflammatory proteins (iP), ENA-78, CD117 and IL-2-R were significantly predictive of DCI in all three compartments in the early phase (iPsyst/CSF/MD). Confirmative diagnosis of DCI (significant difference DCI vs. noDCI on d7-9) was observed in 83 cerebral and 17 systemic iPs (iPCSF/MD, iPsys resp.). Four iPs showed significant difference in all compartments (CCR7, BLR-1, IL17F, IL20). Increased MIF was solely detected in MD probes (p<0.05). Quantitative U-Plex Assay analysis confirmed MD finding of MIF: MIF level was significantly increased in DCId7-9 4159pg/ml [2734–18870] compared to noDCId7-9 216pg/ml [62–3569], (p<0.05).

Conclusion: Single microarray screening identified several potentially predictive and confirmatory inflammatory biomarkers for DCI. Our findings imply a greater sensitivity of screening within the cerebral compartment as documented by an excess number of biomarkers with significant differences from the control group.