| Objective:The present study aimed to investigate the expression of triggering receptor expressed on myeloid cells-1(TREM-1)in cerebrospinal fluid(CSF)of patients with subarachnoid hemorrhage(SAH)and investigate the relationship between TREM-1 and the inflammatory response in early brain injury(EBI)after SAH.Methods:From September 1 to November 30 th 2015,patients with aneurysm SAH from the neurosurgery departments of Shanxi People’s Hospital and the Second Hospital Affiliated to Shanxi Medical University were enrolled as SAH group in this study,while patients who complained of headache but didn’t had SAH,head trauma,brain tumors,infectious aneurysm,meningitis,hematological disorders or other major injuries were recruited in the same period as a control group.CSF specimens from the above groups were collected,while SAH group were collected dynamically and divided into group 2d,3d,4d,5d,6d,7d,8d post-SAH.Among them,group 2d and group 3d were identified as the early onset group after SAH.TREM-1 concentrations in CSF of different groups were detected by enzyme linked immunosorbent assay(ELISA).The number of white blood cell(WBC)counts and C-reactive protein(CRP)in peripheral blood were recorded on admission,and the levels of CSF tumor necrosis factor α(TNF-α)and interleukin-6(IL-6)in the early onset group after SAH were detected as well to assess the intensity of inflammatory response in EBI.The severity of the patient’s condition was assessed by the Glasgow Coma Scale(GCS)and the Hunt-Hess scale.The Glasgow Prognosis Scale(GOS)and the Modified Rankin Scale were used to assess the prognosis of patients.To explore the possible role of early CSF TREM-1 level to the severity and prognosis of SAH,correlations of TREM-1 levels to Glasgow Coma Scale(GCS),Hunt-Hess Scale,Glasgow outcome scale(GOS)and modified Rankin scale were caculated respectively.Then the association between early CSF TREM-1 levels and the inflammatory response in EBI were analyzed.Results:30 SAH patients with aneurysm and 9 controls were enrolled in this study.Also,there are 17 patients in early onset group after SAH.Compared with that of the control group,CSF TREM-1 levels were significantly elevated(P<0.05).Among the 7 SAH groups from day 2 to day 8 after SAH,dynamical changes of CSF TREM-1 levels existed,with an early increase within 2 days and a late peak at day 6 post-SAH.The early CSF TREM-1 levels were significantly correlated with GCS(r=-0.550,P=0.022),Hunt and Hess scale(r=0.603,P=0.010),GOS(r=-0.505,P=0.039)and modified Rankin Scale(r=0.557,P=0.020).In comparison with that of the healthy controls,early CSF levels of TNF-α(t=5.41,P<0.001)and IL-6(t=2.98,P=0.007)increased significantly,as well as plasm WBC(t=7.61,P<0.001)counts and CRP(t=3.91,P=0.001)levels obtained on admission.For the early onset group after SAH,s TREM-1 levels in CSF were positively correlated with that of CSF TNF-α(r=0.582,P=0.014)and IL-6(r=0.593,P=0.012),as well as plasm WBC counts(r=0.629,P=0.007)and CRP levels(r=0.804,P<0.001).Conclusion:1.SAH induced an elevated expression of CSF TREM-1.2.TREM-1 may act as a monitoring biomarker facilitated to assess the severity and prognosis of SAH.3.CSF levels of TREM-1 in SAH patients was significantly correlated with the intensity of inflammatory response of EBI,in which TREM-1 may promote the mass production of inflammatory factors. |
