Effect of intraventricularly administered low-dose recombinant tissue plasminogen activator on interleukin 1-beta and transforming growth factor beta concentrations in cerebrospinal fluid of patients with primary intracerebral hemorrhage associated with intraventricular hemorrhage
| Autor: | Božena Ćurko-Cofek, Igor Antončić, Janja Tarčuković, Matija Sošić, Siniša Dunatov, Alan Šustić, Vlatka Sotošek |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences Intraventricular hemorrhage Neuroinflammation Primary intracerebral hemorrhage Recombinant tissue plasminogen activator Secondary brain injury medicine.medical_treatment Interleukin-1beta intraventricular hemorrhage neuroinflammation primary intracerebral hemorrhage recombinant tissue plasminogen activator secondary brain injury Observational Study Gastroenterology intraventricular hemorrhage neuroinflammation 03 medical and health sciences 0302 clinical medicine Cerebrospinal fluid Fibrinolytic Agents Transforming Growth Factor beta Internal medicine medicine Humans 030212 general & internal medicine Beta (finance) Stroke Saline Aged Cerebral Intraventricular Hemorrhage Retrospective Studies Intracerebral hemorrhage intraventricular hemorrhage neuroinflammation primary intracerebral hemorrhage recombinant tissue plasminogenactivator secondary brain injury biology business.industry BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti General Medicine Transforming growth factor beta Middle Aged medicine.disease primary intracerebral hemorrhage Infusions Intraventricular secondary brain injury 030220 oncology & carcinogenesis Tissue Plasminogen Activator recombinant tissue plasminogen activator biology.protein Female business External ventricular drain Research Article |
| Zdroj: | Medicine Volume 99 Issue 20 |
| ISSN: | 0025-7974 1536-5964 |
| DOI: | 10.1097/md.0000000000019966 |
| Popis: | It is increasingly recognized that modulation of brain inflammation may uncover new potential therapeutic strategies for stroke. Recent studies have shifted focus from immunological implications in ischemic stroke to a more devastating form; the hemorrhagic stroke. The aim of this study was to investigate the neuroinflammatory response in cerebrospinal fluid in patients with primary intracerebral hemorrhage (ICH) associated with intraventricular hemorrhage (IVH) in the presence of low-dose recombinant tissue plasminogen activator (rt-PA). This retrospective study included 88 adults with primary ICH associated with IVH. Patients were divided into 2 groups: rt-PA group and non-rt-PA group, which received normal standard of care for this diagnosis. The rt-PA group was treated via catheter-based clot lysis using low-dose rt-PA injected through the external ventricular drain (EVD) system, and the non-rt-PA group was treated with saline applied to EVD system in equivalent volume. Cerebrospinal fluid samples from rt-PA were obtained from the EVD system at 4 time points: once before the drug administration, and then on day 1, 3, and 7. No attempt at randomization was made. The decision to inject rt-PA was based on the preference of the primary attending neurologist and the ability to obtain consent. Temporal interleukin-1 beta and transforming growth factor beta concentration changes were analyzed and compared between the 2 groups. The concentration of interleukin-1 beta was significantly lower in the rt-PA group than in the non-rt-PA group on day 7. In addition, the concentration of transforming growth factor beta was significantly higher in the rt-PA group than in the non-rt-PA group on day 1. There was a significant difference in interleukin-1 beta concentration between days 0 and 1 in comparison to day 3 in the rt-PA group, and between day 0 in comparison to day 3 and 7 in the non-rt-PA group. We also observed a significant difference in transforming growth factor beta concentration between days 0 and 1 and between days 3 and 7. The different pattern of pro- and anti-inflammatory cytokines in patients with ICH associated with IVH suggest distinct characteristics of secondary brain injury depending on the treatment modality. |
| Databáze: | OpenAIRE |
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