Bache Søren, Rasmussen Rune, Rossing Maria, Laigaard Finn Pedersen, Nielsen Finn Cilius, Møller Kirsten
From the Departments of Neuroanaesthesiology (S.B., K.M.) and Neurosurgery (R.R.), The Neuroscience Centre, and Centre for Genomic Medicine (S.B., M.R., F.C.N.), Rigshospitalet, and Department of Anaesthesia, Frederiksberg Hospital (F.P.L.), University of Copenhagen, Denmark.
Stroke. 2017 Sep;48(9):2391-2398. doi: 10.1161/STROKEAHA.117.017804. Epub 2017 Aug 2.
Delayed cerebral ischemia (DCI) accounts for a major part of the morbidity and mortality after aneurysmal subarachnoid hemorrhage (SAH). MicroRNAs (miRNAs) are pathophysiologically involved in acute cerebral ischemia. This study compared miRNA profiles in cerebrospinal fluid from neurologically healthy patients, as well as SAH patients with and without subsequent development of DCI.
In a prospective case-control study of SAH patients treated with external ventricular drainage and neurologically healthy patients, miRNA profiles in cerebrospinal fluid were screened and validated using 2 different high-throughput real-time quantification polymerase chain reaction techniques. The occurrence of DCI was documented in patient charts and subsequently reviewed independently by 2 physicians.
MiRNA profiles from 27 SAH patients and 10 neurologically healthy patients passed quality control. In the validation, 66 miRNAs showed a relative increase in cerebrospinal fluid from SAH patients compared with neurologically healthy patients (<0.001); 2 (miR-21 and miR-221) showed a relative increase in SAH patients with DCI compared with those without (<0.05) in both the screening and validation.
SAH is associated with marked changes in the cerebrospinal fluid miRNA profile. These changes could be associated to the development of DCI.
URL: http://www.clinicaltrials.gov. Unique identifier: NCT01791257.
迟发性脑缺血（DCI）是动脉瘤性蛛网膜下腔出血（SAH）后发病和死亡的主要原因。微小RNA（miRNA）在急性脑缺血的病理生理过程中发挥作用。本研究比较了神经功能正常患者、发生和未发生DCI的SAH患者脑脊液中的miRNA谱。
在一项对接受脑室外引流治疗的SAH患者和神经功能正常患者的前瞻性病例对照研究中，使用两种不同的高通量实时定量聚合酶链反应技术对脑脊液中的miRNA谱进行筛选和验证。DCI的发生情况记录在患者病历中，随后由两名医生独立审查。
来自27例SAH患者和10例神经功能正常患者的miRNA谱通过了质量控制。在验证中，与神经功能正常的患者相比，66种miRNA在SAH患者的脑脊液中相对增加（<0.001）；在筛查和验证中，2种miRNA（miR-21和miR-221）在发生DCI的SAH患者中比未发生DCI的患者相对增加（<0.05）。
SAH与脑脊液miRNA谱的显著变化有关。这些变化可能与DCI的发生有关。
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