Andrew L A Garton1, Vivek P Gupta2, Brandon R Christophe3, E Sander Connolly3. 1. College of Physicians and Surgeons, Columbia University, New York, New York. Electronic address: andrew.garton@columbia.edu. 2. College of Physicians and Surgeons, Columbia University, New York, New York. 3. Department of Neurosurgery, College of Physicians and Surgeons, Columbia University, New York, New York.
Abstract
BACKGROUND: Intracerebral hemorrhage (ICH) is associated with neurological decline and poor prognosis. Although many etiologic models have been explored, secondary damage caused by continued inflammation and iron exposure from red blood cell lysis may explain poor outcomes at distant follow-up. Examining serum samples of patients with ICH for biomarkers of iron physiology may yield relationships between iron exposure and functional outcomes. METHODS: The following study retrospectively evaluated 41 patient serum samples obtained 1 day and 7 days post-ictus for CD163, ferritin, and hepcidin concentrations. Functional outcomes, using the modified Rankin Scale, were dichotomized into good (0-3) and poor (4-6). Correlation analysis and logistic regression were used to explore relationships between biomarker values, clinical metrics (such as ICH Score), and functional outcomes at 3 and 12 months. RESULTS: Clinical metrics (Acute Physiology and Chronic Health Evaluation II score, ICH Score, and National Institutes of Health Stroke Scale) were correlated with elevated ferritin levels 7 days post-ictus. Furthermore, it was found that mean CD163 levels on day 1 were significantly associated with functional outcomes at 3 and 12 months; mean serum ferritin concentrations on days 1 and 7 were elevated in those with poor outcomes at 3 months, and day 7 levels were independently correlated with 12-month outcomes. CONCLUSION: Although this study serves to contribute to a growing body of evidence that CD163 and ferritin are biomarkers of functional outcomes, prospective cohort studies may clarify the role of iron-related inflammatory biomarkers as they pertain to neurological decline in patients with ICH.
BACKGROUND:Intracerebral hemorrhage (ICH) is associated with neurological decline and poor prognosis. Although many etiologic models have been explored, secondary damage caused by continued inflammation and iron exposure from red blood cell lysis may explain poor outcomes at distant follow-up. Examining serum samples of patients with ICH for biomarkers of iron physiology may yield relationships between iron exposure and functional outcomes. METHODS: The following study retrospectively evaluated 41 patient serum samples obtained 1 day and 7 days post-ictus for CD163, ferritin, and hepcidin concentrations. Functional outcomes, using the modified Rankin Scale, were dichotomized into good (0-3) and poor (4-6). Correlation analysis and logistic regression were used to explore relationships between biomarker values, clinical metrics (such as ICH Score), and functional outcomes at 3 and 12 months. RESULTS: Clinical metrics (Acute Physiology and Chronic Health Evaluation II score, ICH Score, and National Institutes of Health Stroke Scale) were correlated with elevated ferritin levels 7 days post-ictus. Furthermore, it was found that mean CD163 levels on day 1 were significantly associated with functional outcomes at 3 and 12 months; mean serum ferritin concentrations on days 1 and 7 were elevated in those with poor outcomes at 3 months, and day 7 levels were independently correlated with 12-month outcomes. CONCLUSION: Although this study serves to contribute to a growing body of evidence that CD163 and ferritin are biomarkers of functional outcomes, prospective cohort studies may clarify the role of iron-related inflammatory biomarkers as they pertain to neurological decline in patients with ICH.
Authors: Charlotte Jj van Asch; Merel Ja Luitse; Gabriël Je Rinkel; Ingeborg van der Tweel; Ale Algra; Catharina Jm Klijn Journal: Lancet Neurol Date: 2010-01-05 Impact factor: 44.182
Authors: Chao Gao; Hanjian Du; Ya Hua; Richard F Keep; Jennifer Strahle; Guohua Xi Journal: J Cereb Blood Flow Metab Date: 2014-03-26 Impact factor: 6.200
Authors: Jing Xu; Zhouqing Chen; Fang Yu; Huan Liu; Cheng Ma; Di Xie; Xiaoming Hu; Rehana K Leak; Sherry H Y Chou; R Anne Stetler; Yejie Shi; Jun Chen; Michael V L Bennett; Gang Chen Journal: Proc Natl Acad Sci U S A Date: 2020-12-08 Impact factor: 12.779