Background

Aneurysmal subarachnoid hemorrhage (aSAH) is associated with activation of the inflammatory cascade contributing to unfavorable outcome and secondary complications, such as delayed cerebral ischemia (DCI). Both fatty acid–binding protein 3 (FABP3) and CXC-chemokine ligand 16 (CXCL-16) have been linked to vascular inflammation and cellular death. The authors aimed to assess the 30-day prognostic value of serum levels of FABP3 and CXCL-16 and explore their associations with DCI in aSAH patients.

Methods

A total of 60 patients with aSAH were prospectively enrolled. Sampling for markers was done at 24 hours after the index event. FABP3 and CXCL-16 serum concentrations were determined by MilliPlex multiplex immunoassay method. The primary endpoint was unfavorable outcome at Day 30 based on the modified Rankin Scale.

Results

Both FABP3 and CXCL-16 levels were significantly elevated in patients with unfavorable outcome compared to those with favorable outcome after aSAH (FABP3: 2133 pg/mL, IQR: 1053-4567 vs. 3773, 3295-13116; p<0.003 and CXCL-16: 384 pg/mL, 313-502 vs. 498, 456-62, p<0.001). The area under the curve (AUC) for serum CXCL-16 levels as a predictor of unfavorable outcome at Day 30 was 0.747 (95% CI =0.622-0.871; p<0.001). Based on binary logistic regression analysis, serum CXCL-16 with a cut-off level >446.7 ng/L independently predicted Day 30 unfavorable outcome with a sensitivity of 81% and a specificity of 62%. Neither CXCL-16 nor FABP3 showed a significant correlation with DCI.

Conclusion

Early FABP3 and CXCL-16 levels are significantly associated with poor 30-day outcome in patients with aSAH.

中文翻译：

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脂肪酸结合蛋白 3 和 CXC-趋化因子配体 16 与动脉瘤性蛛网膜下腔出血的不良结局相关

背景

动脉瘤性蛛网膜下腔出血 (aSAH) 与炎症级联反应的激活有关，导致不良结果和继发性并发症，例如迟发性脑缺血 (DCI)。脂肪酸结合蛋白 3 (FABP3) 和 CXC-趋化因子配体 16 (CXCL-16) 都与血管炎症和细胞死亡有关。作者旨在评估 FABP3 和 CXCL-16 血清水平的 30 天预后价值，并探讨它们与 aSAH 患者中 DCI 的关联。

方法

共有 60 名 aSAH 患者被前瞻性纳入。在指标事件后 24 小时进行标记物采样。FABP3 和 CXCL-16 血清浓度通过 MilliPlex 多重免疫测定法测定。主要终点是第 30 天基于改良 Rankin 量表的不利结果。

结果

与 aSAH 后预后良好的患者相比，预后不良的患者的 FABP3 和 CXCL-16 水平均显着升高（FABP3：2133 pg/mL，IQR：1053-4567 vs. 3773、3295-13116；p<0.003 和 CXCL- 16：384 pg/mL，313-502 对比 498、456-62，p<0.001)。作为第 30 天不利结果的预测因子的血清 CXCL-16 水平的曲线下面积 (AUC) 为 0.747（95% CI = 0.622-0.871；p<0.001）。基于二元逻辑回归分析，具有 >446.7 ng/L 临界值的血清 CXCL-16 独立预测第 30 天不利结果，敏感性为 81%，特异性为 62%。CXCL-16 和 FABP3 均未显示出与 DCI 的显着相关性。

结论

早期 FABP3 和 CXCL-16 水平与 aSAH 患者的 30 天预后不良显着相关。