Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan.
Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Sci Rep. 2018 Jan 18;8(1):1109. doi: 10.1038/s41598-018-19371-5.
Neurogenesis from endogenous neural stem cells (NSCs) might contribute to functional recovery after stroke based on animal studies; however, the relationship between neurogenesis and post-stroke outcome has rarely been demonstrated in humans. We prospectively collected cerebrospinal fluid (CSF) from 36 patients with subarachnoid hemorrhage (SAH). The CSF was added to the culture medium of the rat NSCs to test the effects on proliferation (proliferation index [PI], percentage of Ki-67 immunoreactive cells). We correlated the PI with functional outcome based on the modified Rankin Scale at 3 months post-SAH. Treatment with the CSF samples collected from SAH patients showed a higher PI compared with those collected from patients with normal pressure hydrocephalus and untreated controls (20.3 ± 8.8 vs. 8.2 ± 5.1 and 7.8 ± 3.0, P < 0.001), indicating proliferation-promoting factors in CSF after SAH. The PI was positively correlated with SAH volume (p = 0.025). For patients with lower SAH volume, patients with favorable outcome had a higher PI than those with poor outcome (20.8 ± 6.9 vs. 14.6 ± 4.3, p = 0.047). Using multivariable logistic regression analysis, the PI was a positive determinant for favorable outcome (odds ratio, 1.17; 95% confidence interval, 1.00 to 1.36) that more proliferation-promoting factors in CSF was associated with better functional outcome in SAH patients.
神经发生（源自内源性神经干细胞）可能有助于基于动物研究的中风后功能恢复；然而，在人类中，神经发生与中风后结局之间的关系很少得到证实。我们前瞻性地从 36 名蛛网膜下腔出血（SAH）患者中收集脑脊液（CSF）。将 CSF 添加到大鼠 NSCs 的培养基中，以测试其对增殖的影响（增殖指数[PI]，Ki-67 免疫反应性细胞的百分比）。我们根据改良后的 Rankin 量表，将 PI 与 3 个月后的中风后功能结局相关联。与来自正常压力脑积水患者和未治疗对照组的 CSF 样本相比，来自 SAH 患者的 CSF 样本处理后表现出更高的 PI（20.3±8.8 比 8.2±5.1 和 7.8±3.0，P<0.001），表明 SAH 后 CSF 中存在促进增殖的因子。PI 与 SAH 体积呈正相关（p=0.025）。对于较低的 SAH 体积患者，预后良好的患者的 PI 高于预后不良的患者（20.8±6.9 比 14.6±4.3，p=0.047）。使用多变量逻辑回归分析，PI 是预后良好的正决定因素（优势比，1.17；95%置信区间，1.00 至 1.36），即 CSF 中更多的促增殖因子与 SAH 患者更好的功能结局相关。
