The predictive value of serum myeloperoxidase for vasospasm in patients with aneurysmal subarachnoid hemorrhage

Lim, Michael; Bower, Regina S.; Wang, Ying; Sims, Leroy; Bower, Mark R.; Camara-Quintana, Joaquin; Li, Gordon; Cheshier, Samuel; Harsh, Griffith R.; Guccione, Samira

doi:10.1007/s10143-012-0375-4

Cited by 22 publications

(13 citation statements)

References 21 publications

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“…More importantly, MPO levels have been shown to be correlated with the severity and outcome of vascular disease, making it a highly promising biomarker for diagnosis and staging. 10,11 In addition to its role in inflammation, MPO mediates oxidative cell stress due to the production of reactive oxygen species. Chlorination of lipoproteins and nitrosylation of matrix proteins by MPO are thought to contribute to vessel wall damage.…”

Section: Discussionmentioning

confidence: 99%

Myeloperoxidase in Human Intracranial Aneurysms

Gounis

Vedantham

Weaver

et al. 2014

Stroke

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Background and Purpose Non-invasive imaging identifying a predictive biomarker of the bleeding risk of unruptured intracranial aneurysms (UIA) is needed. We investigated a potential biomarker of UIA instability, myeloperoxidase (MPO), in human aneurysm tissue. Methods Human brain aneurysms were harvested following clipping, and histologically and biochemically evaluated for the presence of MPO. Of the tissue collected, 3 were from ruptured aneurysms and 20 were from UIAs. For each UIA, its 5-year aneurysm rupture risk (ARR) was determined using the PHASES model. Results All ruptured aneurysms were MPO-positive. Of the UIAs, half were MPO-positive. The median 5-year ARR was higher for MPO-positive UIA (2.28%) than MPO-negative UIA (0.69%) and the distributions were statistically different (p<0.005, Wilcoxon-Mann-Whitney test). The likelihood for MPO-positive UIA was significantly associated (p=0.031) with ARR (Odds Ratio: 4.79; 95% confidence limits: 1.15–19.96). Conclusion MPO is associated with PHASES estimated risk of aneurysm rupture and may potentially be used as an imaging biomarker of aneurysm instability.

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Section: Discussionmentioning

confidence: 99%

Myeloperoxidase in Human Intracranial Aneurysms

Gounis

Vedantham

Weaver

et al. 2014

Stroke

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“…This is in accordance with two previous studies (Moritz et al, 2010; Jung et al, 2013). The need of a marker in predicting cerebral vasospasm still remains, and other biomarkers such as myeloperoxidase (Lim et al, 2012), amino acids in addition to microdialysis (Jung et al, 2013), endothelin-1, interleukin-6, and indicators of thrombin activity might be of greater utility (Lad et al, 2012). …”

Section: Discussionmentioning

confidence: 99%

Can S100B Predict Cerebral Vasospasms in Patients Suffering from Subarachnoid Hemorrhage?

2013

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Background: Protein S100B has proven to be a useful biomarker for cerebral damages. Increased levels of serum and cerebrospinal fluid (CSF) S100B have been shown in patients suffering subarachnoid hemorrhage (SAH), severe head injury and stroke. In patients with SAH, the course of S100B levels has been correlated with neurological deficits and outcome. Cerebral vasospasm is a major contributor to morbidity and mortality. The primary aim of this study was to investigate the potential of S100B protein as a predictor of cerebral vasospasm in patients with severe SAH.Materials and Methods: Patients with SAH, Fisher grade 3 and 4, were included in the study. Five samples of CSF and serum S100B were collected from each patient. The first sample (baseline sample) was drawn within the first 3 days following ictus and the following four samples, once a day on days 5–8, with day of ictus defined as day 1. Clinical suspicion of cerebral vasospasm confirmed by computed tomography angiography was used to diagnose cerebral vasospasm.Results: A total of 18 patients were included. Five patients (28%) developed cerebral vasospasm, two (11%) developed ventriculitis. There were no significant differences between S100B for those with and without vasospasm. Serum S100B levels in patients with vasospasm were slightly lower within the first 5 days following ictus, compared to patients without vasospasm. Two out of five patients had elevated and increasing serum S100B prior to vasospasm. Only one showed a peak level of S100B 1 day before vasospasm could be diagnosed. Due to the low number of patients in the study, statistical significance could not be reached.Conclusion: Neither serum nor CSF S100B can be used as predictor of cerebral vasospasm in patients suffering from SAH.

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“…8–10 MPO is increased in blood of CA patients during SAH and vasospasm. 11 It is not known, however, whether MPO is increased locally within CA. It is also not known whether MPO contributes to CA formation and rupture, although a study suggests that MPO presence in human CA tissue is positively correlated with 5-year aneurysm rupture risk.…”

Section: Introductionmentioning

confidence: 99%

Myeloperoxidase Is Increased in Human Cerebral Aneurysms and Increases Formation and Rupture of Cerebral Aneurysms in Mice

Chu

Wilson

et al. 2015

Stroke

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Background and purpose Cerebral aneurysm (CA) affects 3% of the population and is associated with hemodynamic stress and inflammation. Myeloperoxidase (MPO), a major oxidative enzyme associated with inflammation, is increased in CA patients, but whether MPO contributes to CA is not known. We tested the hypotheses that MPO is increased within human CA and is critical for formation and rupture of CA in mice. Methods Blood was drawn from the lumen of CAs and femoral arteries of 25 patients who underwent endovascular coiling of CA, and plasma MPO concentrations were measured with ELISA. Effects of endogenous MPO on CA formation and rupture were studied in MPO knockout (KO) mice and wild-type (WT) mice using an angiotensin II-elastase induction model of CA. In addition, effects of MPO on inflammatory gene expression in endothelial cells were analyzed. Results Plasma concentrations of MPO were 2.7-fold higher within CA than in femoral arterial blood in CA patients. MPO-positive cells were increased in aneurysm tissue compared with superficial temporal artery of CA patients. Incidence of aneurysms and subarachnoid hemorrhage was significantly lower in MPO KO than in WT mice. In cerebral arteries, proinflammatory molecules including TNFα, COX2, CXCL1, MMP8, CD68 and MMP13, and leukocytes were increased, and α-smooth muscle actin was decreased, in WT but not in MPO KO mice after induction of CA. MPO per se increased expression of VCAM1 and ICAM1 in endothelial cells. Conclusions These findings suggest that MPO may contribute importantly to formation and rupture of CA.

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The predictive value of serum myeloperoxidase for vasospasm in patients with aneurysmal subarachnoid hemorrhage

Cited by 22 publications

References 21 publications

Myeloperoxidase in Human Intracranial Aneurysms

Myeloperoxidase in Human Intracranial Aneurysms

Can S100B Predict Cerebral Vasospasms in Patients Suffering from Subarachnoid Hemorrhage?

Myeloperoxidase Is Increased in Human Cerebral Aneurysms and Increases Formation and Rupture of Cerebral Aneurysms in Mice

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