The Influence of Oxidative Stress on Neurological Outcomes in Spontaneous Intracerebral Hemorrhage

Abstract

Spontaneous intracerebral hemorrhage (ICH) causes, besides the primary brain injury, a secondary brain injury (SBI), which is induced, amongst other things, by oxidative stress (OS) and inflammation, determining the patient’s outcome. This study aims to assess the impact of OS in plasma and cerebrospinal fluid (CSF) on clinical outcomes in patients with ICH. A total of 19 ICH (volume > 30 cc) patients and 29 control patients were included. From day one until seven, blood and CSF samples were obtained, and ICH volume was calculated. OS markers, like malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), glutathione-sulfhydryl (GSH), and the total antioxidant status (TAS) were measured. Clinical data on treatment and outcome were determined. Patients with mRS ≤ 4 showed significantly elevated SOD and GSH-Px levels in plasma compared to patients with poor CO (p = 0.004; p = 0.002). Initial increased TAS in plasma and increased MDA in CSF were linked to an unfavorable outcome after six months (p = 0.06, r = 0.45; p = 0.05, r = 0.44). A higher ICH volume was associated with a worse outcome at week six (p = 0.04, r = 0.47). OS plays a significant role in SBI. Larger ICHs, elevated MDA in CSF, and TAS in plasma were associated with a detrimental outcome, whereas higher plasma-SOD and -GSH-Px were associated with a favorable outcome.

Protective role of wogonin following traumatic brain injury by reducing oxidative stress and apoptosis via the PI3K/Nrf2/HO‑1 pathway

“…The main physiological functions of GSH are scavenging free radicals, anti-oxidation and anti-aging. The present study also found that plasma levels of GSH was decreased significantly in ICH patients from days 1-7, however, this trend was not statistically significant ( 34 ). The results of the present study also showed that GSH levels declined gradually over time in the TBI group; notably, there was no statistically significant comparison between the groups.…”

Oxidant/Antioxidant Status Is Impaired in Sepsis and Is Related to Anti-Apoptotic, Inflammatory, and Innate Immunity Alterations

“…The intra-assay and inter-assay CVs were 3.1% and 5.1%, respectively; the detection limit was 7 mmol/L. TAC was measured by a colorimetric test system (ImAnOx kit, Immundiagnostik AG, Stubenwald-Allee 8a, and D 64,625 Bensheim, Germany) [ 18 , 19 ], which reflects the sum of all antioxidant components, through an enzymatic reaction of sample antioxidants with a defined amount of exogenously provided H 2 O 2 . The antioxidants in the sample eliminate a certain amount of the provided H 2 O 2 , which involves the conversion of tetramethylbenzidine to a colored product measured at 450nm wavelength.…”

Secondary Brain Injury by Oxidative Stress After Cerebral Hemorrhage: Recent Advances

“…Researchers have studied the impact of OS in plasma and cerebrospinal fluid (CSF) of patients with ICH on their clinical outcomes. The results showed that elevated MDA in CSF and total antioxidant status in plasma were associated with harmful outcomes, while higher plasma SOD and GSH-Px were associated with favorable outcomes in ICH (Masomi-Bornwasser et al, 2021 ). This reflects the predictive power of oxidative markers for ICH outcomes.…”