Intracerebral Proinflammatory Cytokine Increase in Surgically Evacuated Intracerebral Hemorrhage: A Microdialysis Study.

Szczegóły
Abstrakt

Tytuł:: Intracerebral Proinflammatory Cytokine Increase in Surgically Evacuated Intracerebral Hemorrhage: A Microdialysis Study.
Autorzy:: Tobieson L; Departments of Neurosurgery in Linköping and Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden. .
Gard A; Department of Clinical Sciences Lund, Neurosurgery, Lund University, Lund, Sweden.
Ruscher K; Department of Clinical Sciences Lund, Neurosurgery, Lund University, Lund, Sweden.
Marklund N; Department of Clinical Sciences Lund, Neurosurgery, Lund University, Lund, Sweden.; Department of Clinical Sciences Lund, Neurosurgery, Lund University, Skåne University Hopsital, Lund, Sweden.
Źródło:: Neurocritical care [Neurocrit Care] 2022 Jun; Vol. 36 (3), pp. 876-887. Date of Electronic Publication: 2021 Nov 30.
Typ publikacji:: Journal Article; Observational Study
Język:: English
Imprint Name(s):: Original Publication: Totowa, NJ : Humana Press, c2004-
MeSH Terms:: Cerebral Hemorrhage*/pathology
Cytokines*/metabolism
Inflammation Mediators*/metabolism
Humans ; Microdialysis ; Vascular Endothelial Growth Factor A
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Contributed Indexing:: Keywords: Brain injury; Cytokine; Inflammation mediators; Intracranial hemorrhage; Microdialysis; Stroke
Substance Nomenclature:: 0 (Cytokines)
0 (Inflammation Mediators)
0 (Vascular Endothelial Growth Factor A)
Entry Date(s):: Date Created: 20211201 Date Completed: 20220519 Latest Revision: 20220901
Update Code:: 20240105
PubMed Central ID:: PMC9110446
DOI:: 10.1007/s12028-021-01389-9
PMID:: 34850333
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Background: Treatment options for spontaneous intracerebral hemorrhage (ICH) are limited. A possible inflammatory response in the brain tissue surrounding an ICH may exacerbate the initial injury and could be a target for treatment of subsequent secondary brain injury. The study objective was to compare levels of inflammatory mediators in the interstitial fluid of the perihemorrhagic zone (PHZ) and in seemingly normal cortex (SNX) in the acute phase after surgical evacuation of ICH, with the hypothesis being that a difference could be demonstrated between the PHZ and the SNX.
Methods: In this observational study, ten patients needing surgical evacuation of supratentorial ICH received two cerebral microdialysis catheters: one in the PHZ and one in the SNX that is remote from the ICH. The microdialysate was analyzed for energy metabolites (including lactate pyruvate ratio and glucose) and for inflammatory mediators by using a multiplex immunoassay of 27 cytokines and chemokines at 6-10 h, 20-26 h, and 44-50 h after surgery.
Results: A metabolic crisis, indicated by altered energy metabolic markers, that persisted throughout the observation period was observed in the PHZ when compared with the SNX. Proinflammatory cytokines interleukin (IL) 8, tumor necrosis factor α, IL-2, IL-1β, IL-6 and interferon γ, anti-inflammatory cytokine IL-13, IL-4, and vascular endothelial growth factor A were significantly higher in PHZ compared with SNX and were most prominent at 20-26 h following ICH evacuation.
Conclusions: Higher levels of both proinflammatory and anti-inflammatory cytokines in the perihemorrhagic brain tissue implies a complex role for inflammatory mediators in the secondary injury cascades following ICH surgery, suggesting a need for targeted pharmacological interventions.
(© 2021. The Author(s).)

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