Sun Xin-Gang, Ma Qian, Jing Gang, Wang Li, Hao Xu-Dong, Wang Gai-Qing
Department of Neurology, The Second Hospital Affiliated to Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China.
Clinical Laboratory, the Second Hospital Affiliated to Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China.
Neurol Sci. 2017 May;38(5):873-877. doi: 10.1007/s10072-017-2853-5. Epub 2017 Feb 22.
Early brain injury (EBI) contributes to poor prognosis of subarachnoid hemorrhage (SAH). This study aimed to clarify whether triggering receptor expressed on myeloid cells-1 (TREM-1) was implicated in the inflammatory mechanisms of EBI. The cerebrospinal fluid (CSF) levels of soluble TREM-1 (sTREM-1), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) as well as plasma levels of white blood cells (WBC) count and C-reactive protein in 17 SAH patients at early stage (within the EBI period) and 9 volunteers were observed. Also World Federation of Neurosurgical Societies (WFNS) scale of SAH patients was calculated on admission. Compared to controls, increased CSF levels of sTREM-1 (t = 5.66, P < 0.001), TNF-α (t = 5.41, P < 0.001) and IL-6 (t = 2.98, P = 0.007) as well as elevated plasma WBC counts (t = 7.61, P < 0.001) and C-reactive protein levels (t = 3.91, P = 0.001) were found in SAH patients. Considering the increased WBC counts in SAH group, covariate analysis was also performed when comparing patients' sTREM-1 levels with respect to controls and no obvious difference was found (F = 0.982, P = 0.332). For SAH group, early CSF concentrations of sTREM-1 were correlated with those of both TNF-α (r = 0.582, P = 0.014) and IL-6 (r = 0.593, P = 0.012). Also the CSF sTREM-1 levels were positively correlated with WBC counts (r = 0.629, P = 0.007) and C-reactive protein levels (r = 0.804, P < 0.001) as well as WFNS scale (r = 0.835, P < 0.001). This study showed an early increased sTREM-1 CSF level in SAH patients, which correlated with inflammation intensity post-SAH and clinical severity, indicating that TREM-1 may participate in the inflammatory mechanisms of EBI.
早期脑损伤（EBI）会导致蛛网膜下腔出血（SAH）的预后不良。本研究旨在阐明髓样细胞表达的触发受体-1（TREM-1）是否与EBI的炎症机制有关。观察了17例早期（EBI期内）SAH患者和9名志愿者的脑脊液（CSF）中可溶性TREM-1（sTREM-1）、肿瘤坏死因子-α（TNF-α）和白细胞介素-6（IL-6）水平，以及血浆中白细胞（WBC）计数和C反应蛋白水平。同时计算了SAH患者入院时的世界神经外科协会联合会（WFNS）评分。与对照组相比，SAH患者CSF中sTREM-1水平升高（t = 5.66，P < 0.001）、TNF-α水平升高（t = 5.41，P < 0.001）和IL-6水平升高（t = 2.98，P = 0.007），血浆WBC计数升高（t = 7.61，P < 0.001）和C反应蛋白水平升高（t = 3.91，P = 0.001）。考虑到SAH组WBC计数增加，在比较患者与对照组的sTREM-1水平时还进行了协变量分析，未发现明显差异（F = 0.982，P = 0.332）。对于SAH组，早期CSF中sTREM-1浓度与TNF-α（r = 0.582，P = 0.014）和IL-6（r = 0.593，P = 0.012）均相关。此外，CSF中sTREM-1水平与WBC计数（r = 0.629，P = 0.007）、C反应蛋白水平（r = 0.804，P < 0.001）以及WFNS评分（r = 0.835，P < 0.001）均呈正相关。本研究显示SAH患者CSF中sTREM-1水平早期升高，这与SAH后的炎症强度和临床严重程度相关，表明TREM-1可能参与EBI的炎症机制。
