Myeloperoxidase in human intracranial aneurysms: preliminary evidence.
OBJECTIVE
Noninvasive imaging identifying a predictive biomarker of the bleeding risk of unruptured intracranial aneurysms (UIAs) is needed. We investigated a potential biomarker of UIA instability, myeloperoxidase, in human aneurysm tissue.


METHODS
Human brain aneurysms were harvested after clipping and were histologically and biochemically evaluated for the presence of myeloperoxidase. Of the tissue collected, 3 were from ruptured aneurysms and 20 were from UIAs. For each UIA, its 5-year aneurysm rupture risk was determined using the Population, Hypertension, Age, Size of Aneurysm, Earlier Subarachnoid Hemorrhage From Another Aneurysm and Site of Aneurysm (PHASES) model.


RESULTS
All ruptured aneurysms were myeloperoxidase positive. Of the UIAs, half were myeloperoxidase positive. The median 5-year aneurysm rupture risk was higher for myeloperoxidase-positive UIA (2.28%) than myeloperoxidase-negative UIA (0.69%), and the distributions were statistically different (P<0.005, Wilcoxon-Mann-Whitney test). The likelihood for myeloperoxidase-positive UIA was significantly associated (P=0.031) with aneurysm rupture risk (odds ratio, 4.79; 95% confidence limits, 1.15-19.96).


CONCLUSIONS
Myeloperoxidase is associated with PHASES estimated risk of aneurysm rupture and may potentially be used as an imaging biomarker of aneurysm instability.
From the Departments of Radiology (M.J.G., S.V., A.S.P., C.S.B., A.K.W., A.A.B.) and Neurosurgery (J.P.W., A.S.P., A.K.W.), University of Massachusetts, Worcester.
Matthew J
MJ
Gounis
Srinivasan
S
Vedantham
John P
JP
Weaver
Ajit S
AS
Puri
Christopher S
CS
Brooks
Ajay K
AK
Wakhloo
Alexei A
AA
Bogdanov
D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000201:enzymology / Q000378:metabolism* / Q000473:pathology; D015415:Biomarkers / Q000378:metabolism; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000201:enzymology / Q000378:metabolism* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009195:Peroxidase / Q000378:metabolism*; D010865:Pilot Projects; D012306:Risk; D013997:Time Factors
D015415:Biomarkers; D009195:Peroxidase
biomarker; inflammation; intracranial aneurysm