Open AccessCCL 2 and CXCL 10 are associated with poor outcome after intracerebral hemorrhage
Author(s) -
Landreneau Margaret J.,
Mullen Michael T.,
Messé Steven R.,
Cucchiara Brett,
Sheth Kevin N.,
McCullough Louise D.,
Kasner Scott E.,
Sansing Lauren H.
Publication year - 2018
Publication title -
annals of clinical and translational neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.824
H-Index - 42
ISSN - 2328-9503
DOI - 10.1002/acn3.595
Subject(s) - medicine , intracerebral hemorrhage , modified rankin scale , prospective cohort study , cohort , subarachnoid hemorrhage , ischemic stroke , ischemia
Objective Intracerebral hemorrhage carries a high mortality and survivors are frequently left with significant disability. Immunological mechanisms may play an important role in hemorrhage‐induced brain injury, however, research linking these mechanisms with clinical outcome remains limited. We aim to identify serum inflammatory mediators that are associated with outcome after intracerebral hemorrhage in order to translate data from experimental models to a patient cohort and identify potential targets worthy of reverse translation. Methods A prospective cohort study at two comprehensive stroke centers enrolled patients with spontaneous intracerebral hemorrhage. Peripheral blood was collected at 6, 24, and 72 h from onset. Functional outcome was assessed at 90 days using the modified Rankin Scale ( mRS ). Serum inflammatory mediators were measured using multiplex ELISA . Multivariable modeling identified serum biomarkers independently associated with functional outcome at 90 days. Results 115 patients completed the study. At 6 h after onset, patients with elevated CCL 2 had worse mRS score at day 90 ( OR 4.07, 95% CI 1.27–13.10, P = 0.02) after adjusting for age, gender, ICH volume, IVH , infratentorial location and NIHSS score. At 24 and 72 h after onset, elevation in CXCL 10 was independently associated with worse 90 days mRS score (24 h: OR 8.08, 95% CI 2.69–24.30, P < 0.001; 72 h: OR 3.89, 95% CI 1.12–13.49, P = 0.03). Interpretation Acute and subacute elevations in specific immune factors are associated with poor outcome, highlighting potential pathways that may contribute to ongoing brain injury in patients with intracerebral hemorrhage.