title: Inflammasome Proteins in Cerebrospinal Fluid of Patients with Subarachnoid Hemorrhage are Biomarkers of Early Brain Injury and Functional Outcome.
abstract: BACKGROUND
  Aneurysmal subarachnoid hemorrhage (SAH) remains a devastating disease with significant morbidity and mortality. To date, clinical variables are still used to evaluate injury severity and prognosis. This study was designed to investigate the role of cerebrospinal fluid (CSF) inflammasome proteins as laboratory-based biomarkers of brain injury severity and outcome in SAH patients.
  
  
  METHODS
  Ten control patients and 24 SAH patients were prospectively enrolled in this study. CSF samples were collected within 72 hours after SAH. Levels of inflammasome proteins in the CSF, including NLRP1, ASC, and caspase-1 were analyzed.
  
  
  RESULTS
  Immunoblot analysis exhibited that levels of NLRP1, ASC and caspase-1 were elevated in the CSF of SAH patients (P < 0.0001, P = 0.0178, and P < 0.0001, respectively). In the group of SAH patients, these inflammasome proteins were significantly higher in the patients with cerebral edema on computed tomographic scans (P = 0.0002, P = 0.0005, and P = 0.0004, respectively), and in the patients with acute hydrocephalus (P = 0.0009, P = 0.00017, and P = 0.0016, respectively). Higher levels of inflammasome proteins were associated with severe SAH and poor outcome 3 months after the SAH. High level of NLRP1 was the independent risk factor of poor outcome after SAH (P = 0.049, odds ratio = 1.730).
  
  
  CONCLUSIONS
  Inflammasome proteins are potential biomarkers to assess early brain injury and to predict functional outcome after SAH.
authors.affiliation: Department of Neurosurgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Wu
authors.affiliation: Department of Neurosurgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
authors.forename: Xiao-Liang
authors.initials: XL
authors.lastname: Wang
authors.affiliation: Department of Clinical Laboratory, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Yu
authors.affiliation: Department of Neurosurgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Pan
authors.affiliation: Department of Neurosurgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
authors.forename: Xiang-Sheng
authors.initials: XS
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
authors.forename: Qing-Rong
authors.initials: QR
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China. Electronic address: njhdwang@hotmail.com.
authors.forename: Han-Dong
authors.initials: HD
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China. Electronic address: zhangxsp@163.com.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000134:cerebrospinal fluid; D001930:Brain Injuries / Q000134:cerebrospinal fluid* / Q000175:diagnosis* / Q000209:etiology; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D058847:Inflammasomes / Q000134:cerebrospinal fluid*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D020127:Recovery of Function; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013345:Subarachnoid Hemorrhage / Q000134:cerebrospinal fluid* / Q000150:complications / Q000175:diagnosis*; D015599:Trauma Severity Indices
chemical_list: D015415:Biomarkers; D058847:Inflammasomes
keywords: Biomarkers; Inflammasome; Subarachnoid hemorrhage