Early Elevation of Serum Tumor Necrosis Factor-α Is Associated With Poor Outcome in Subarachnoid Hemorrhage. (1st October 2012)

• Record Type: Journal Article
• Authors: Chou, Sherry H.-Y.; Feske, Steven K.; Atherton, Juli; Konigsberg, Rachael G.; De Jager, Philip L.; Du, Rose; Ogilvy, Christopher S.; Lo, Eng H.; Ning, MingMing
• Is Part Of: Journal of investigative medicine. Volume 60:Number 7(2012)
• Page Start: 1054
• Page End: 1058
• Publication Date: 2012-10-01
• Subjects: biomarker -- subarachnoid hemorrhage -- tumor necrosis factor alpha -- inflammation; Clinical medicine -- Periodicals; Medicine -- Research -- Periodicals; Medicine; Research -- United States; Clinical medicine; Medicine -- Research; Periodicals; 616.075
• DOI: 10.2310/JIM.0b013e3182686932
• Languages: English
• ISSNs: 1081-5589

Abstract

Abstract : Objective: Subarachnoid hemorrhage (SAH) is associated with inflammation that may mediate poor outcome in SAH. We hypothesize that elevated serum tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6) are associated with vasospasm and poor outcome in SAH. Methods: In 52 consecutive SAH subjects, we compared TNF-α and IL-6 levels on post-SAH days 0 to 1, 2 to 3, 4 to 5, 6 to 8, and 10 to 14 with respect to vasospasm and to poor outcome at 3 and 6 months. Vasospasm was defined as more than 50% reduction in vessel caliber on angiography. Poor outcome was defined as modified Rankin score greater than 2. Results: Elevated TNF-α on post-SAH days 2 to 3 was associated with poor 3-month outcome ( P = 0.0004). Global elevation of TNF-α over time (post-SAH days 0–14) was independently associated with poor 3-month outcome after adjusting for Hunt-and-Hess grade and age ( P = 0.02). Neither cross-sectional nor IL-6 levels over time were associated with outcome. Neither TNF-α nor IL-6 levels were associated with vasospasm. Conclusions: Elevation in serum TNF-α on post-SAH days 2 to 3 and global elevation of TNF-α over time are associated with poor outcome but not with angiographic vasospasm in this small cohort. Future studies are needed to define the role of TNF-α in SAH-related brain injury and its potential as a SAH outcome biomarker.