MicroRNAs as Biomarkers for Predicting Complications following Aneurysmal Subarachnoid Hemorrhage

Abstract

Aneurysmal subarachnoid hemorrhage (aSAH) is a high mortality hemorrhagic stroke that affects nearly 30,000 patients annually in the United States. Approximately 30% of aSAH patients die during initial hospitalization and those who survive often carry poor prognosis with one in five having permanent physical and/or cognitive disabilities. The poor outcome of aSAH can be the result of the initial catastrophic event or due to the many acute or delayed neurological complications, such as cerebral ischemia, hydrocephalus, and re-bleeding. Unfortunately, no effective biomarker exists to predict or diagnose these complications at a clinically relevant time point when neurologic injury can be effectively treated and managed. Recently, a number of studies have demonstrated that microRNAs (miRNAs) in extracellular biofluids are highly associated with aSAH and complications. Here we provide an overview of the current research on relevant human studies examining the correlation between miRNAs and aSAH complications and discuss the potential application of using miRNAs as biomarkers in aSAH management.

Admission Serum Iron as an Independent Risk Factor for Postoperative Delayed Cerebral Ischemia Following Aneurysmal Subarachnoid Hemorrhage: A Propensity-Matched Analysis

“…Aneurysmal subarachnoid hemorrhage (aSAH), characterized by the extravasation of blood into the subarachnoid space caused by intracranial aneurysm rupture [ 1 , 2 ], is a life-threatening hemorrhagic stroke with high mortality and disability rate [ 3 ]. One major complication is the delayed cerebral ischemia (DCI), developing in approximately 22–33% of patients [ 4 , 5 , 6 , 7 ], between 5 and 14 days (peak at 5–7 days) after SAH [ 3 , 8 ], and is consistently related to adverse clinical outcome and permanent disability [ 9 , 10 ]. Clinical identification of DCI is often challenging since hypotension, rebleeding, infection, hypoxia, hydrocephalus, and sedatives can produce a similar clinical manifestation [ 8 , 11 ].…”

Admission Lower Serum Phosphate Ion Levels Predict Acute Hydrocephalus of Aneurysmal Subarachnoid Hemorrhage

“…Numerous factors, including female sex, elderly age, higher mFisher grade, intraventricular hemorrhage, and laboratory findings, have been reported in prior literature to predict the occurrence of aHCP following aSAH (1,7,8,10,11). In recent years, considerable efforts have been focused on studying sensitive biomarkers for predicting aHCP (12)(13)(14), but reports of these biomarkers on the risk factors for aHCP development are inconsistent and controversial (13)(14)(15)(16). Clinically, laboratory biomarkers have received extensive attention and research due to their convenience, practicality, and sensitivity (17).…”

Molecular Mechanisms and Pathophysiology of Acute Stroke: Emphasis on Biomarkers in the Different Stroke Subtypes

“…This Special Issue is aimed at understanding some of the most novel pathophysiological and molecular aspects of acute stroke and at providing a critical overview of the underlying factors involved in stroke-related brain injury, emphasizing mainly the most promising protein, genetics and epigenetic biomarkers. This Special Issue includes ten papers [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ], two original articles and eight review papers ( Table 1 ).…”

“…A total of six articles analyze cerebral infarctions [ 6 , 9 , 11 , 12 , 14 , 15 ], one intracerebral hemorrhage [ 13 ], one subarachnoid hemorrhage [ 7 ] and two analyzed globally stroke [ 8 , 10 ]. Emphasis is also placed on the different etiological subtypes, assessing lacunar-type cerebral ischemia [ 9 ], atherothrombotic infarcts [ 6 , 12 ], spontaneous intracerebral hemorrhage [ 10 , 13 ], subarachnoid hemorrhage [ 7 ] and on post-stroke consequences, including vascular-type cognitive impairment [ 8 ] and post-stroke lung damage [ 15 ].…”

“…In a review paper, Wang et al [ 7 ] summarized the recent literature reporting the role of microRNAs as biomarkers in aneurysmal subarachnoid hemorrhage (aSAH) management, a hemorrhagic stroke subtype with high mortality. Biofluid miRNAs hold great potential as biomarkers for aSAH and its complications (such as delayed brain injury by cerebral vasospasm, hydrocephalus and re-bleeding).…”