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Background Intracerebral hemorrhage (ICH) pathophysiology involves inflammation. Macrophage migration inhibition factor (MIF), a pro-inflammatory cytokine, is related to prognosis of ischemic stroke. The aim of this study was to investigate whether serum MIF levels are associated with severity and outcomes in patients with acute ICH. Methods We enrolled a total of 120 consecutive ICH patients and 120 healthy controls and sampled blood on admission and at study entry respectively. Enzyme-linked immunosorbent assay was used to quantify serum MIF levels. Results Serum MIF levels were higher in patients compared with controls and correlated with hematoma volume, National Institutes of Health Stroke Scale (NIHSS) scores and plasma C-reactive protein levels. After adjusting for other significant outcome predictors, MIF in serum was an independent predictor of 6-month overall survival and unfavorable outcome (modified Rankin Scale score > 2). Areas under receiver-operating characteristic curve (ROC) of serum MIF levels, hematoma volume and NIHSS scores were similar for 6-month unfavorable outcome. Moreover, serum MIF levels significantly improved areas under ROC of hematoma volume and NIHSS scores. Conclusions MIF in serum might be a potential biomarker for reflecting inflammation, severity and prognosis of ICH patients. [ABSTRACT FROM AUTHOR]

Objective: Delayed cerebral ischemia (DCI) greatly contributes to the high morbidity and mortality of aneurysmal subarachnoid hemorrhage (aSAH) patients. Expression of lectin‐like oxidized low‐density lipoprotein receptor‐1 (LOX‐1) was substantially raised in the basilar arterial wall of SAH rabbits. We attempted to ascertain the relationship between serum soluble LOX‐1 (sLOX‐1) levels and the occurrence of DCI after aSAH. Materials and methods: We enrolled 125 aSAH patients and 125 healthy controls. Serum sLOX‐1 levels were quantified using commercial enzyme‐linked immunosorbent assay kit. The relationship between sLOX‐1 levels and DCI was analyzed utilizing the multivariate logistic regression analysis. Results: Serum sLOX‐1 levels were significantly higher in stroke patients than in controls (median: 1,450.2 vs. 445.7 pg/ml, p <.001). Serum sLOX‐1 levels were highly correlated with World Federation of Neurological Surgeons (WFNS) scores, Hunt‐Hess scores, and modified Fisher scores (r =.574,.625, and.569, respectively). Forty‐two patients (33.6%) experienced DCI. Serum sLOX‐1 > 1,450.2 pg/ml, WFNS scores and modified Fisher scores were the independent predictors of DCI. Under receiver operating characteristic curve, serum sLOX‐1 levels exhibited a significant discriminatory capability (area under curve 0.825, 95% confidence interval 0.747–0.887). The predictive power of serum sLOX‐1 levels was similar to those of WFNS scores and modified Fisher grade (both p >.05). Moreover, serum sLOX‐1 levels significantly improved their predictive capability (both p <.05). Conclusions: Serum soluble LOX‐1, in positive association with hemorrhagic severity, appears to have the potential to become a promising predictor of DCI after aSAH. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

• Serum sTWEAK levels are strongly correlated with hemorrhagic severity after aSAH. • Serum sTWEAK levels are intimately related to brain inflammation after aSAH. • Serum sTWEAK levels are markedly raised in aSAH patients with a 6-month poor outcome. • Serum sTWEAK levels are independently associated with a 6-month poor outcome of aSAH patients. • Serum sTWEAK levels display a high predictive ability for a 6-month poor outcome following aSAH. Tumor necrosis factor-like weak inducer of apoptosis (TWEAK) might contribute to brain inflammation after acute brain injury. The current study was designed to investigate whether serum soluble TWEAK (sTWEAK) can serve as a potential biomarker for functional outcome after aneurysmal subarachnoid hemorrhage (aSAH). In this single-center prospective, observational study, admission serum sTWEAK concentrations were quantified among 112 aSAH patients. Impact of serum sTWEAK concentrations on a poor outcome (Glasgow outcome scale score 1–3) at 6 months after stroke onset was determined using multivariate analysis. Admission serum sTWEAK concentrations were intimately correlated with serum C-reactive protein concentrations, World Federation of Neurological Surgeons scores and modified Fisher scores. A total of 38 patients (33.9%) had a poor outcome at post-hemorrhagic 6 months. Admission serum sTWEAK concentrations were substantially higher in patients with a poor outcome than in the other remainders. Under receiver operating characteristic curve, serum sTWEAK concentrations significantly distinguished a poor outcome. Serum sTWEAK concentrations > 3.23 ng/ml discriminated the risk of a poor outcome with medium-high sensitivity and specificity and independently predicted a poor outcome. Serum sTWEAK, in close correlation with inflammation and hemorrhagic severity, might represent a potential biomarker for predicting clinical outcome after aSAH. [ABSTRACT FROM AUTHOR]