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Lookup NU author(s): Justin Nissen,
Dr David Mantle,
Dr Barbara Gregson,
Emeritus Professor David Mendelow
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Objectives-Adhesion molecules are involved in the pathogenesis of cerebral ischaemia and may play a part in the pathophysiology of delayed ischaemic neurological deficit (DIND) after aneurysmal subarachnoid haemorrhage. It was hypothesised that after aneurysmal subarachnoid haemorrhage, adhesion molecules may play a part in the pathophysiology of DIND as reflected by significantly altered serum concentrations in patients with and without DIND. Methods-In a prospective study, mean serum concentrations of ICAM-1, VCAM-1, PECAM, and E, P, and L-selectin were compared between patients without (n = 23) and with (n = 13) DIND in patients with World Federation of Neurological Surgeons (WFNS) grades 1 or 2 subarachnoid haemorrhage. Serum was sampled from patients within 2 days of haemorrhage and on alternate days until discharge. Concentrations of adhesion molecules were measured by standard procedures using commercially available enzyme linked immunoabsorbent assays. Results-There were non-significant differences in serum concentrations of ICAM-1 (290.8 ng/ml v 238.4 ng/ml, p = 0.0525), VCAM-1 (553.2 ng/ml v 425.8 ng/ml, p = 0.053), and PECAM (22.0 ng/ml v 21.0 ng/ml p = 0.56) between patients without and with DIND respectively. The E-selectin concentration between the two patient groups (44.0 ng/ml v 37.4 ng/ml, p = 0.33) was similar. The P-selectin concentration, however, was significantly higher in patients with DIND compared with those patients without DIND (149.5 ng/ml v 112.9 ng/ml, p = 0.039). By contrast, serum L-selectin concentrations were significantly lower in patients with DIND (633.8 ng/ml v 897.9 ng/ml, p = 0.013). Conclusions-Of all the adhesion molecules examined in this study, P and L-selectin are involved in the pathophysiology of DIND after aneurysmal subarachnoid haemorrhage.
Author(s): Mendelow AD; Gregson B; Mantle D; Nissen JJ
Publication type: Article
Publication status: Published
Journal: Journal of Neurology Neurosurgery and Psychiatry
ISSN (print): 0022-3050
Publisher: BMJ Publishing Group Ltd
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