title: Thioredoxin as a marker for severity and prognosis of aneurysmal subarachnoid hemorrhage.
abstract: OBJECTIVE
  Circulating levels of thioredoxin (Trx), a potent anti-oxidant that modulates inflammation, cell growth and apoptosis, are increased in various critical care conditions. The purpose of this study was to establish the relationship between serum Trx levels and prognosis of aneurysmal subarachnoid hemorrhage (aSAH).
  
  
  METHODS
  An enzyme-linked immunosorbent assay measurement of Trx was performed in serum from 132 patients and 132 healthy volunteers. Clinical outcomes included 6-month mortality and unfavorable outcome (Glasgow outcome scale score of 1-3).
  
  
  RESULTS
  The serum Trx levels were significantly higher in patients than in controls (23.4±12.2 ng/mL vs.8.5±4.0 ng/mL, P<0.001) and had close relation to the World Federation of Neurological Surgeons (WFNS) scores (r=0.461, P<0.001) and modified Fisher scores (r=0.459, P<0.001). Trx was an independent predictor for 6-month mortality (Odds ratio, 1.386; 95% confidence interval, 1.015-2.161; P<0.001) and 6-month unfavorable outcome (Odds ratio, 1.297; 95% confidence interval, 1.012-2.002; P<0.001). Based on receiver operating characteristic curve, TRX had similar prognostic value compared with WFNS scores and modified Fisher scores and also significantly improved their prognostic value for 6-month unfavorable outcome, but not for 6-month mortality.
  
  
  CONCLUSIONS
  Elevated plasma Trx levels are correlated with the severity and poor prognosis, substantializing Trx as a potential prognostic predictive biomarker following aSAH.
authors.affiliation: Department of Neurosurgery, The Central Hospital of Wenzhou City, 32 Dajian Lane, Wenzhou 325000, China.
authors.forename: Jun-Xia
authors.initials: JX
authors.lastname: Dai
authors.affiliation: Department of Neurosurgery, The Central Hospital of Wenzhou City, 32 Dajian Lane, Wenzhou 325000, China.
authors.forename: Jian-Yong
authors.initials: JY
authors.lastname: Cai
authors.affiliation: Department of Neurosurgery, The Central Hospital of Wenzhou City, 32 Dajian Lane, Wenzhou 325000, China.
authors.forename: Qun
authors.initials: Q
authors.lastname: Lin
authors.affiliation: Department of Neurosurgery, The Central Hospital of Wenzhou City, 32 Dajian Lane, Wenzhou 325000, China.
authors.forename: Xian-Dong
authors.initials: XD
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, The Central Hospital of Wenzhou City, 32 Dajian Lane, Wenzhou 325000, China.
authors.forename: Chuan
authors.initials: C
authors.lastname: Lu
authors.affiliation: Department of Neurosurgery, The Central Hospital of Wenzhou City, 32 Dajian Lane, Wenzhou 325000, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Sun
authors.affiliation: Department of Neurosurgery, The Central Hospital of Wenzhou City, 32 Dajian Lane, Wenzhou 325000, China. Electronic address: xiexieie@163.com.
authors.forename: Hua-Jun
authors.initials: HJ
authors.lastname: Ba
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D013345:Subarachnoid Hemorrhage / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality; D013879:Thioredoxins / Q000097:blood*
chemical_list: D015415:Biomarkers; D013879:Thioredoxins
keywords: Aneurysm; Prognosis; Severity; Subarachnoid hemorrhage; Thioredoxin