| BACKGROUD:Subarachnoid haemorrhage(SAH)remains an important cause of premature death and disability,and CVS,one of the main complications after SAH,occurs in 70%of patients between days 4-14.Yet up to now,the occurrence of CVS still cannot be clarified clearly.Hence,identification of a biomarker could be useful to the diagnosis and potential treatment of this complication.Platelet-derived growth factor(PDGF),as a member of large growth factor family,can mediate angiogenesis and the survival of cells which is similar to vascular endothelial growth factor structurally and functionally.Therefore,we supposed that patients who suffered from CVS may experience a pathological process including hypoxia and ischemia,and the hypoxia and ischemia may dysfunction the pericytes so that what PDGFRβon pericytes shed from pericytes result in the increasing of sPDGFRβ in CSF.sPDGFRβ may be a biomaker for diagnosing and treating of CVS potentially.Materials and methodsThis study was approved by the regional Research Ethics Committee of Jinling hospital,Jiangsu.Written informed consent was obtained from the patients or,for comatose patients,from the next of kin.Thirty-two consecutive patients admitted to the neuro-critical care unit(ICU)of our department of neurosurgery for diagnosing aneurysmal SAH from Nov 2015 to April 2016.To exclude the effect of surgery,patients who suffered aneurysm embolization were enrolled only.The CSF was collected from 32 SAH patients who had undergone cerebral artery aneurysm embolization on daysl-3,days4-6,and days7-9 serially after operations.After disinfecting carefully and the dead space had been removed,3ml of CSF was withdrawn from the cisternal drainage tube or external ventricular drainage tube that had been installed as part of the standard care.sPDGFRβ was analyzed twice for each sample using an enzyme-linked immunosorbent assayResultsThirty-two patients,20 females and 12 males,were included in this study.The age was 55.7± 12.3(from 18 to 78)years averagely.The elevated concentrations of sPDGFRβfollowing SAH on daysl-3The concentrations of sPDGFRβ on days 1-3[averagely 886.93 pg/ml(range 433.36-1312.48pg/ml)pg/ml]were higher compared to control subjects[484.04pg/ml(298.39-693.48)pg/ml(p=0.0012)](Figure 1A).For the CSF collected were repeated measurement data,so we had not put them all together.Separately,compared the concentrations of sPDGFRβ with the normal on days 1-3,we found them increased significantly.The CSF concentrations of sPDGFRβ at three different times(days 1-3,4-6,and 7-9)had been analyzed and the peak concentration presented in days 7-9(886.93±242.86 pg/ml vs 1229.07±513.69 pg/ml vs 1338.13±468.30 pg/ml,p<0.001).The appropriate ROC curve revealed a moderate diagnostic value of sPDGFRβ for predicting CVS(AUC=0.680,p=0.082).Allowing for the relatively small number of patients included,the cutoff for sPDGFRβ was defined as 975.38 pg/ml according to the ROC curve.Notably the patients compared with CVS had a higher level of sPDGFRβ than that of whom didn’t(973.46±239.23pg/ml vs 788.85±213.99pg/ml,p=0.029).Furthermore,we found a moderate correlation between CVS and the CSF sPDGFRβ concentrations(Chi-square=5.542,p=0.019,r=0.416,p=0.018).sPDGFRβ was found to be an independent predictor for CVS(p=0.001,OR=19.22,95%CI:3.27-113.03).Other significant predictors of CVS were age(p<0.001,OR=0.024,95%CI:0.004-0.157)and WFNS IV-V(p=0.061,OR=5.196,95%CI:1-29.16).Failed to predict of outcome at 6 months with CSF sPDGFRβ concentrations.ConclusionIncreased sPDGFRβ in CSF after SAH support the role of sPDGFRβ as a biomaker of pericytes and neurons injury and is higher in patients who accompany with CVS.sPDGFRβon days 1-3 may be a predictor of CVS after SAH.These findings provide information complementary to clinical data for early CVS diagnosis and treatment potentially after SAH. |
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