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血清性腺激素、炎症蛋白与脑出血结局的探索性初步分析

Pilot Exploratory Analysis of Serum Gonadal Hormones, Inflammatory Proteins, and Intracerebral Hemorrhage Outcomes.

作者信息

Ng Yisi, Qi Wenjing, Covington Anna, Boone Bobby, Kuhn Cynthia, Nixon Andrew B, King Nicolas Kon Kam, Kranz Peter F, Christianson Thomas, Thakkar Roshni, Laskowitz Daniel T, Sasannejad Cina, Bhima Miran, Krishnamoorthy Vijay, Shah Shreyansh, Wagner Amy K, James Michael L

机构信息

Duke-NUS Medical School, Singapore 169857, Singapore.

Brain Injury Translational Research Center, Duke University, Durham, NC 27710, USA.

出版信息

Int J Mol Sci. 2025 Aug 28;26(17):8334. doi: 10.3390/ijms26178334.

Abstract

Intracerebral hemorrhage (ICH) remains the least treatable form of stroke, with inflammation implicated as a major pathophysiological feature. Hence, this study sought to associate serum proteins and hormones associated with inflammation and ICH outcomes. Patients presenting to Duke University Hospital with computed tomography-verified spontaneous, supratentorial, non-traumatic ICH within 24 h of symptom onset were prospectively recruited. In this pilot study, equal numbers of men and women and Black and White individuals were included and matched by a 6-month modified Rankin Score (mRS). The primary analyses were the correlation of L-ratios (LR; Log2(Day 2/Day 1 concentrations)) of serum gonadal hormones and neuroinflammatory proteins with mRS > 3 at 6 months. A total of 40 participants were included in this pilot study. LRs were significantly higher for C-reactive protein (CRP; = 0.013) and lower for interleukin-6 (IL-6; = 0.026) and surfactant protein-D ( = 0.036) in participants with unfavorable outcomes at 6 months after ICH. Further, higher CRP ( = 0.02) and lower IL-6 ( = 0.035) and surfactant protein-D ( = 0.041) LRs were associated with mRS > 3 at 6 months after ICH in multiple logistic regression analyses, adjusted for race and sex. The relationship amongst gonadal hormones, neuroinflammatory proteins, and ICH outcome is complex. In this pilot study, unfavorable outcomes after ICH may have been associated with selected inflammatory biomarkers. A larger scale study is warranted to define interactions between hormones, proteins, and their effects on ICH outcomes.

摘要

脑出血(ICH)仍然是最难以治疗的中风形式,炎症被认为是主要的病理生理特征。因此,本研究旨在关联与炎症及脑出血预后相关的血清蛋白和激素。前瞻性招募了症状发作后24小时内到杜克大学医院就诊、经计算机断层扫描证实为自发性、幕上、非创伤性脑出血的患者。在这项初步研究中,纳入了数量相等的男性和女性以及黑人和白人个体,并根据6个月改良Rankin量表(mRS)进行匹配。主要分析是血清性腺激素和神经炎症蛋白的L比率(LR;Log2(第2天/第1天浓度))与6个月时mRS>3的相关性。本初步研究共纳入40名参与者。脑出血后6个月预后不良的参与者中,C反应蛋白(CRP;P = 0.013)的LR显著更高,而白细胞介素-6(IL-6;P = 0.026)和表面活性蛋白-D(P = 0.036)的LR更低。此外,在根据种族和性别进行调整的多因素逻辑回归分析中,较高的CRP(P = 0.02)以及较低的IL-6(P = 0.035)和表面活性蛋白-D(P = 0.041)的LR与脑出血后6个月时mRS>3相关。性腺激素、神经炎症蛋白和脑出血预后之间的关系很复杂。在这项初步研究中,脑出血后的不良预后可能与某些炎症生物标志物有关。有必要进行更大规模的研究来确定激素、蛋白质之间的相互作用及其对脑出血预后的影响。

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