Walsh Kyle B, Campos Begoña, Hart Kimberly, Thakar Charuhas, Adeoye Opeolu
Department of Emergency Medicine, University of Cincinnati (UC), Cincinnati, Ohio; UC Neuroscience Institute, Cincinnati, Ohio.
Department of Internal Medicine, Division of Nephrology, UC, Cincinnati, Ohio; UC Kidney C.A.R.E. (Clinical Advancement, Research & Education) Program, Cincinnati, Ohio.
J Stroke Cerebrovasc Dis. 2017 Oct;26(10):2369-2375. doi: 10.1016/j.jstrokecerebrovasdis.2017.05.027. Epub 2017 Jun 9.
Intracerebral hemorrhage (ICH) is a severe neurologic condition with no proven treatment. Recent evidence suggests that monocytes, a heterogenous group of cells with M1 and M2 phenotypes, contribute to secondary damage following ICH. Microparticles are vesicles .1-1 µm in size that are released from cells. We hypothesized that M1 and M2 monocyte microparticles (mMP) would be differentially expressed in ICH cases and controls.
In a single-center, prospective, observational study, consecutive ICH cases were enrolled within 12 hours of symptom onset. Age (±5 years)-, race-, and sex-matched controls were recruited. M1 and M2 mMP numbers were determined in plasma samples using flow cytometry and protein biomarkers using standardized assays. The Mann-Whitney U test compared M1 and M2 mMP counts between cases and controls. Standardized regression coefficients compared M1 and M2 mMP with C-reactive protein (CRP) and serum amyloid A (SAA).
Nineteen ICH case-control pairs were enrolled. The median number of M1 mMP was not significantly different between ICH cases (8.63 × 10/milliliter (mL)) compared with controls (8.64 × 10/mL), (P = .525). The median number of M2 mMP was significantly higher in ICH cases (1.61 × 10/mL) compared with controls (4.46 × 10/mL) (P = .027). There were no significant associations for M1 or M2 mMP with CRP or SAA.
Higher numbers of M2 mMP in ICH cases compared with controls is hypothesis generating. It may represent differences in the chronic inflammatory status in patients susceptible to ICH, such as cellular activation or apoptosis. Further research is needed, including serial plasma samples, to elucidate the pathophysiology of monocytes and mMP following ICH.
脑出血(ICH)是一种严重的神经系统疾病,尚无经证实的治疗方法。最近的证据表明,单核细胞是一组具有M1和M2表型的异质性细胞,在脑出血后会导致继发性损伤。微粒是大小为0.1 - 1微米的小泡,由细胞释放。我们假设M1和M2单核细胞微粒(mMP)在脑出血病例和对照中会有差异表达。
在一项单中心、前瞻性、观察性研究中,连续的脑出血病例在症状出现后12小时内入组。招募年龄(±5岁)、种族和性别匹配的对照。使用流式细胞术测定血浆样本中的M1和M2 mMP数量,并使用标准化检测方法测定蛋白质生物标志物。采用曼-惠特尼U检验比较病例组和对照组之间的M1和M2 mMP计数。标准化回归系数比较M1和M2 mMP与C反应蛋白(CRP)和血清淀粉样蛋白A(SAA)。
纳入了19对脑出血病例对照。与对照组(8.64×10/毫升(mL))相比,脑出血病例中M1 mMP的中位数无显著差异(8.63×10/mL),(P = 0.525)。与对照组(4.46×10/mL)相比,脑出血病例中M2 mMP的中位数显著更高(1.61×10/mL)(P = 0.027)。M1或M2 mMP与CRP或SAA之间无显著关联。
与对照组相比,脑出血病例中M2 mMP数量更多,这引发了一些假设。这可能代表了易患脑出血患者慢性炎症状态的差异,如细胞活化或凋亡。需要进一步研究,包括连续采集血浆样本,以阐明脑出血后单核细胞和mMPs的病理生理学。