Cargando…

Systemic Inflammatory Response in Spontaneous Subarachnoid Hemorrhage from Aneurysmal Rupture versus Subarachnoid Hemorrhage of Unknown Origin

OBJECTIVE: It is well known that spontaneous non-aneurysmal subarachnoid hemorrhage (SAH), also known as sine materia SAH (smSAH), has usually a better course and prognosis than its aneurysmal counterpart (aSAH). This might depend on different inflammatory mechanisms initiated by bleeding events of...

Descripción completa

Detalles Bibliográficos
Autores principales: Bacigaluppi, Susanna, Bragazzi, Nicola L, Ivaldi, Federico, Benvenuto, Federica, Uccelli, Antonio, Zona, Gianluigi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9676007/
https://www.ncbi.nlm.nih.gov/pubmed/36415221
http://dx.doi.org/10.2147/JIR.S380101
_version_ 1784833497137938432
author Bacigaluppi, Susanna
Bragazzi, Nicola L
Ivaldi, Federico
Benvenuto, Federica
Uccelli, Antonio
Zona, Gianluigi
author_facet Bacigaluppi, Susanna
Bragazzi, Nicola L
Ivaldi, Federico
Benvenuto, Federica
Uccelli, Antonio
Zona, Gianluigi
author_sort Bacigaluppi, Susanna
collection PubMed
description OBJECTIVE: It is well known that spontaneous non-aneurysmal subarachnoid hemorrhage (SAH), also known as sine materia SAH (smSAH), has usually a better course and prognosis than its aneurysmal counterpart (aSAH). This might depend on different inflammatory mechanisms initiated by bleeding events of different origins. The aim of the present study was to explore the systemic inflammatory response in spontaneous SAH, comparing aSAH and smSAH. METHODS: We performed a prospective observational study over a consecutive series of patients with SAH. For these patients, we collected all clinical data and, furthermore, performed venous blood sampling over six time points to analyze blood cells. We further performed the analysis of lymphocytes and monocytes by means of flow cytometry to quantify common subtypes. Statistical analysis included a t-student test, Chi-square test, multivariate logistic regression, and ROC analysis. RESULTS: 48 patients were included: six (12.5%) with a diagnosis of spontaneous smSAH, and forty-two patients (87.5%) with aSAH. Significant differences on Day 0 were found for neutrophils and a systemic neuro-inflammatory index, namely, systemic inflammatory response index (SIRI). At the ROC analysis, neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and SIRI exhibited satisfactory predictive power on day 0. At the multivariable logistic regression analysis, the combined index (NLR, LMR, SIRI at day 0) yielded an OR of 0.59 (95% CI 0.29–1.21]). LMR at day 0 yielded an OR of 1.25 ([95% CI 0.94–1.68]), NLR at day 0 exhibited an OR of 0.68 ([95% CI 0.42–1.09]), and SIRI at day 0 displayed an OR of 0.31 ([95% CI 0.06–1.49]). CONCLUSION: This preliminary study indicated a possible role of some inflammatory indices that point out the importance of innate and adaptive immunity in the etiopathogenetic mechanisms. Drugs modulating these responses could eventually counteract or, at least, reduce secondary damage associated with SAH.
format Online
Article
Text
id pubmed-9676007
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Dove
record_format MEDLINE/PubMed
spelling pubmed-96760072022-11-21 Systemic Inflammatory Response in Spontaneous Subarachnoid Hemorrhage from Aneurysmal Rupture versus Subarachnoid Hemorrhage of Unknown Origin Bacigaluppi, Susanna Bragazzi, Nicola L Ivaldi, Federico Benvenuto, Federica Uccelli, Antonio Zona, Gianluigi J Inflamm Res Original Research OBJECTIVE: It is well known that spontaneous non-aneurysmal subarachnoid hemorrhage (SAH), also known as sine materia SAH (smSAH), has usually a better course and prognosis than its aneurysmal counterpart (aSAH). This might depend on different inflammatory mechanisms initiated by bleeding events of different origins. The aim of the present study was to explore the systemic inflammatory response in spontaneous SAH, comparing aSAH and smSAH. METHODS: We performed a prospective observational study over a consecutive series of patients with SAH. For these patients, we collected all clinical data and, furthermore, performed venous blood sampling over six time points to analyze blood cells. We further performed the analysis of lymphocytes and monocytes by means of flow cytometry to quantify common subtypes. Statistical analysis included a t-student test, Chi-square test, multivariate logistic regression, and ROC analysis. RESULTS: 48 patients were included: six (12.5%) with a diagnosis of spontaneous smSAH, and forty-two patients (87.5%) with aSAH. Significant differences on Day 0 were found for neutrophils and a systemic neuro-inflammatory index, namely, systemic inflammatory response index (SIRI). At the ROC analysis, neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and SIRI exhibited satisfactory predictive power on day 0. At the multivariable logistic regression analysis, the combined index (NLR, LMR, SIRI at day 0) yielded an OR of 0.59 (95% CI 0.29–1.21]). LMR at day 0 yielded an OR of 1.25 ([95% CI 0.94–1.68]), NLR at day 0 exhibited an OR of 0.68 ([95% CI 0.42–1.09]), and SIRI at day 0 displayed an OR of 0.31 ([95% CI 0.06–1.49]). CONCLUSION: This preliminary study indicated a possible role of some inflammatory indices that point out the importance of innate and adaptive immunity in the etiopathogenetic mechanisms. Drugs modulating these responses could eventually counteract or, at least, reduce secondary damage associated with SAH. Dove 2022-11-16 /pmc/articles/PMC9676007/ /pubmed/36415221 http://dx.doi.org/10.2147/JIR.S380101 Text en © 2022 Bacigaluppi et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Bacigaluppi, Susanna
Bragazzi, Nicola L
Ivaldi, Federico
Benvenuto, Federica
Uccelli, Antonio
Zona, Gianluigi
Systemic Inflammatory Response in Spontaneous Subarachnoid Hemorrhage from Aneurysmal Rupture versus Subarachnoid Hemorrhage of Unknown Origin
title Systemic Inflammatory Response in Spontaneous Subarachnoid Hemorrhage from Aneurysmal Rupture versus Subarachnoid Hemorrhage of Unknown Origin
title_full Systemic Inflammatory Response in Spontaneous Subarachnoid Hemorrhage from Aneurysmal Rupture versus Subarachnoid Hemorrhage of Unknown Origin
title_fullStr Systemic Inflammatory Response in Spontaneous Subarachnoid Hemorrhage from Aneurysmal Rupture versus Subarachnoid Hemorrhage of Unknown Origin
title_full_unstemmed Systemic Inflammatory Response in Spontaneous Subarachnoid Hemorrhage from Aneurysmal Rupture versus Subarachnoid Hemorrhage of Unknown Origin
title_short Systemic Inflammatory Response in Spontaneous Subarachnoid Hemorrhage from Aneurysmal Rupture versus Subarachnoid Hemorrhage of Unknown Origin
title_sort systemic inflammatory response in spontaneous subarachnoid hemorrhage from aneurysmal rupture versus subarachnoid hemorrhage of unknown origin
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9676007/
https://www.ncbi.nlm.nih.gov/pubmed/36415221
http://dx.doi.org/10.2147/JIR.S380101
work_keys_str_mv AT bacigaluppisusanna systemicinflammatoryresponseinspontaneoussubarachnoidhemorrhagefromaneurysmalruptureversussubarachnoidhemorrhageofunknownorigin
AT bragazzinicolal systemicinflammatoryresponseinspontaneoussubarachnoidhemorrhagefromaneurysmalruptureversussubarachnoidhemorrhageofunknownorigin
AT ivaldifederico systemicinflammatoryresponseinspontaneoussubarachnoidhemorrhagefromaneurysmalruptureversussubarachnoidhemorrhageofunknownorigin
AT benvenutofederica systemicinflammatoryresponseinspontaneoussubarachnoidhemorrhagefromaneurysmalruptureversussubarachnoidhemorrhageofunknownorigin
AT uccelliantonio systemicinflammatoryresponseinspontaneoussubarachnoidhemorrhagefromaneurysmalruptureversussubarachnoidhemorrhageofunknownorigin
AT zonagianluigi systemicinflammatoryresponseinspontaneoussubarachnoidhemorrhagefromaneurysmalruptureversussubarachnoidhemorrhageofunknownorigin