title: Cerebrospinal fluid pentraxin 3 early after subarachnoid hemorrhage is associated with vasospasm.
abstract: OBJECTIVE
  To investigate plasma and cerebrospinal fluid (CSF) concentrations of pentraxin 3 (PTX3), a prototypic long pentraxin protein induced by proinflammatory signals, in subarachnoid hemorrhage (SAH), and its relation with SAH-associated vasospasm.
  
  
  METHODS
  Serial plasma and CSF samples were collected from 38 consecutive SAH patients admitted to the Neurosurgical Intensive Care. PTX3 concentrations were analyzed in relation to clinical status and clinical vasospasm (defined as neuro-worsening and angiographic confirmation of vessel narrowing). Since neutrophils are an important source of preformed PTX3, myeloperoxidase (MPO) in CSF was measured to assess the correlation with CSF PTX3 and establish whether blood contamination was the determinant of PTX3 increase.
  
  
  RESULTS
  PTX3 was elevated in all SAH patients both in plasma and CSF. Acute peak (first 48 h after SAH) CSF PTX3 was significantly higher in patients who later developed vasospasm [median 13.6 (range 2.3-51.9) ng/ml] compared to those who did not [3.2 (0.1-50.5) ng/ml, p = 0.03]. The temporal pattern of CSF PTX3 in patients with vasospasm was triphasic with a peak during the first 48 h after SAH, a subsequent decrease in the following 48-96 h and a secondary significant increase with the occurrence of vasospasm. A loose correlation between CSF PTX3 and MPO was observed (r(2) = 0.13), indicating that following SAH there is a brain production of PTX3.
  
  
  CONCLUSIONS
  Acute increased concentrations of PTX3 in CSF but not in plasma are related to the occurrence of vasospasm, indicating that measurement of CSF PTX3 associated with the clinical evaluation can improve early diagnosis of this complication.
authors.affiliation: Department of Neuroscience, Laboratory of Inflammation and Nervous System Diseases, Mario Negri Institute for Pharmacological Research, via Giuseppe La Masa, 19, 20156 Milan, Italy.
authors.forename: Elisa R
authors.initials: ER
authors.lastname: Zanier
authors.forename: Giovanna
authors.initials: G
authors.lastname: Brandi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Peri
authors.forename: Luca
authors.initials: L
authors.lastname: Longhi
authors.forename: Tommaso
authors.initials: T
authors.lastname: Zoerle
authors.forename: Mauro
authors.initials: M
authors.lastname: Tettamanti
authors.forename: Cecilia
authors.initials: C
authors.lastname: Garlanda
authors.forename: Anna
authors.initials: A
authors.lastname: Sigurtà
authors.forename: Serenella
authors.initials: S
authors.lastname: Valaperta
authors.forename: Alberto
authors.initials: A
authors.lastname: Mantovani
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: De Simoni
authors.forename: Nino
authors.initials: N
authors.lastname: Stocchetti
mesh_terms: D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000134:cerebrospinal fluid*; D002555:Cerebrospinal Fluid / Q000378:metabolism*; D003422:Critical Care; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000683:Serum Amyloid P-Component / Q000134:cerebrospinal fluid*; D013345:Subarachnoid Hemorrhage / Q000097:blood / Q000134:cerebrospinal fluid / Q000150:complications*; D020301:Vasospasm, Intracranial / Q000097:blood / Q000134:cerebrospinal fluid / Q000150:complications / Q000175:diagnosis / Q000378:metabolism*; D000099153:Pentraxins
chemical_list: D002097:C-Reactive Protein; D000683:Serum Amyloid P-Component; D000099153:Pentraxins