Objective:To analyze the early expression of lipocalin-2 (LCN2) in serum and cerebrospinal fluid of patients with aneurysmal subarachnoid hemorrhage (aSAH), and to explore its correlation with the severity of early brain injury (EBI). Methods: Patients who were diagnosed with aSAH and onset within 3 days in the Department of Neurology of Baotou Central Hospital from 2020 to 2022 were selected as the aSAH group, other patients with the matched age and gender during the same period were selected as the control group. The levels of serum and cerebrospinal fluid LCN2 and cerebrospinal fluid LCN2 levels at different time points were determined by ELISA. The severity of brain injury was assessed by Hunt-Hess scale and divided into three groups: group I: Hunt-Hess grade I, group II: Hunt-Hess grade II and group Ⅲ: Hunt-Hess grade Ⅲ-Ⅴ. To analyze the correlation between the severity of EBI, the levels of serum and cerebrospinal fluid LCN2. Results: A total of 47 patients enrolled. The levels of serum and the cerebrospinal fluid LCN2 in the aSAH group were both higher than those in the control group, and the differences were statistically significant (P<0.001). The levels of serum and the cerebrospinal fluid LCN2 in the group II were both higher than those in the group I, and the differences were statistically significant (P<0.05). The levels of serum and cerebrospinal fluid LCN2 in the group III were both higher than those in the group II, and the differences were statistically significant (P<0.05). Meanwhile, Hunt-Hess grade was positively correlated with levels of serum LCN2 and cerebrospinal fluid LCN2, and the difference was statistically significant (rs>0, P<0.05). ROC curve shows that the area under ROC curve of the serum LCN2 was 0.876 (the specificity was 100.00%, the sensitivity was 61.70%), and the best predictive diagnostic limit was 45.68 ng/mL. The area under ROC curve of the cerebrospinal fluid LCN2 was 0.914 (the specificity was 76.60%,the sensitivity was 100.00%), and the best predictive diagnostic limit was 15.08 ng/mL. Conclusions: The LCN2 level of the body fluid in aSAH patients increased significantly in the early stage, which is closely related to EBI and may be involved with the pathogenesis of EBI.
ZHAO Liying
,
ZHAO Shijun
,
GENG Shangyong
,
ZHAO Xinhui
,
YANG Junfeng
,
JIAN Wenhui
. Early expression of LCN2 in serum and cerebrospinal fluid of patients with aneurysmal subarachnoid hemorrhage[J]. Journal of Baotou Medical College, 2024
, 40(7)
: 48
-52
.
DOI: 10.16833/j.cnki.jbmc.2024.07.008
[1] Ingall T, Asplund K, Mahonen M, et al. A multinational comparison of subarachnoid hemorrhage epidemiology in the WHO MONICA stroke study[J]. Stroke, 2000, 31(5): 1054-1061.
[2] 赵元立. 提倡急性自发性蛛网膜下腔出血的早期外科治疗—兼论临床诊疗指南的重要意义[J]. 中国卒中杂志, 2008(5): 309-310.
[3] Sehba FA, Hou J, Pluta RM, et al. The importance of early brain injury after subarachnoid hemorrhage[J]. Prog Neurobiol, 2012, 97(1): 14-37.
[4] Broderick JP, Brott TG, Duldner JE, et al. Initial and recurrent bleeding are the major causes of death following subarachnoid hemorrhage[J]. Stroke, 1994, 25(7): 1342-1347.
[5] Lee JY, Keep RF, He Y, et al. Hemoglobin and iron handling in brain after subarachnoid hemorrhage and the effect of deferoxamine on early brain injury[J]. J Cereb Blood Flow Metab, 2010, 30(11): 1793-1803.
[6] Wenners AS, Mehta K, Loibl S, et al. Neutrophil gelatinase-associated lipocalin (NGAL) predicts response to neoadjuvant chemotherapy and clinical outcome in primary human breast cancer[J]. PloS One, 2012, 7(10): e45826.
[7] Kim SL, Min IS, Park YR, et al. Lipocalin 2 inversely regulates TRAIL sensitivity through p38 MAPK-mediated DR5 regulation in colorectal cancer[J]. Int J Oncol, 2018, 53(6): 2789-2799.
[8] Barrera-Chimal J, Bobadilla NA. Are recently reported biomarkers helpful for early and accurate diagnosis of acute kidney injury[J]. Biomarkers, 2012, 17(5): 385-393.
[9] Jha MK, Lee S, Park DH, et al. Diverse functionalroles of lipocalin-2 in the central nervous system[J]. Neurosci Biobehav Rev, 2015, 49: 135-156.
[10] Toyota Y, Wei JL, Xi GH, et al. White matter T2 hyperintensities and blood-brain barrier disruption in the hyperacute stage of subarachnoid hemorrhage in male mice: the role of lipocalin-2[J]. CNS Neurosci Ther, 2019, 25(10): 1207-1214.
[11] Yu F, Saand A, Xing CH, et al. CSF lipocalin-2 increases early in subarachnoid hemorrhage are associated with neuroinflammation and unfavorable outcome[J]. J Cereb Blood Flow Metab, 2021, 41(10): 2524-2533.
[12] Rathore KI, Berard JL, Redensek A, et al. Lipocalin 2 plays an immunomodulatory role and has detrimental effects after spinal cord injury[J]. J Neurosci, 2011, 31(38): 13412.
[13] Egashira Y, Hua Y, Keep RF, et al. Acute white matter injury after experimental subarachnoid hemorrhage: potential role of lipocalin 2[J]. Stroke, 2014, 45(7): 2141.
[14] Egashira Y, Hua Y, Keep RF, et al. Lipocalin 2 and blood-brain barrier disruption in white matter after experimental subarachnoid hemorrhage[J]. Acta Neurochir Suppl, 2016, 121: 131-134.
[15] Devireddy LR, Gazin C, Zhu X, et al. A cell-surface receptor for lipocalin 24p3 selectively mediates apoptosis and iron uptake[J]. Cell, 2005, 123(7): 1293-1305.