Timing of Serum Soluble HLA-G Levels in Acute and Subacute Phases After Spontaneous Intracerebral Hemorrhage
Serum levels of sHLA-G (sHLA-G1/HLA-G5) antigens and their soluble isoforms, sHLA-G1 and HLA-G5, were measured by ELISA in 22 patients with spontaneous intracerebral hemorrhage (SICH) at 24 h, 48 h and 7 days after bleeding. The perihematomal edema volume
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stract Serum levels of sHLA-G (sHLA-G1/HLA-G5) antigens and their soluble isoforms, sHLA-G1 and HLAG5, were measured by ELISA in 22 patients with spontaneous intracerebral hemorrhage (SICH) at 24 h, 48 h and 7 days after bleeding. The perihematomal edema volume was calculated on non-enhanced computed tomography scans using the formula A×B×C/2 at the same time points. The mean serum concentrations of sHLA-G1/HLA-G5 and sHLA-G1 as well as the perihematomal edema volume changed significantly over time (p < 0.0001, p < 0.001 and p < 0.0001, respectively), whereas no statistical differences were found in serum HLA-G5 concentrations over the course of the experiment. In comparison to the values found at 24 h, sHLA-G1/HLA-G5 and sHLA-G1 increased at 48 h and then decreased at 7 days, whereas the perihematomal edema volume was more elevated at 48 h and, to a lesser extent, at 7 days. A positive correlation was detected between mean serum sHLA-G1/HLA-G5 and sHLA-G1 levels and perihematomal edema volume at 24 h (p < 0.02) and at 48 h (p < 0.01). Our results may indicate a role for sHLA-G in inflammatory mechanisms related to SICH, where these proteins probably act as anti-inflammatory molecules and are predominantly produced as the sHLA-G1 isoform. Keywords sHLA-G1 • HLA-G5 • spontaneous intracerebral hemorrhage • perihematomal brain edema
E. Fainardi and V. Ramponi Neuroradiology Unit, Department of Neurosciences and Rehabilitation, Azienda Ospedaliera-Universitaria, Arcispedale S. Anna Corso della Giovecca 203, 44100 Ferrara, Italy R. Rizzo, M. Stignani, and O.R. Baricordi Section of Medical Genetics, Department of Experimental and Diagnostic Medicine, University of Ferrara, 44100 Ferrara, Italy A. Lupato, G. De Santis, C. Tamborino, M. Castellazzi, and I. Casetta, Section of Neurology, Department of Medical and Surgical Sciences of the Communication and Behaviour, University of Ferrara, Arcispedale S. Anna Corso della Giovecca 203, 44100 Ferrara, Italy Francesco Garofano Neurosurgery Unit, Department of Neurosciences and Rehabilitation, Azienda Ospedaliera-Universitaria, Arcispedale S. Anna Corso della Giovecca 203, 44100 Ferrara, Italy
Introduction Spontaneous intracerebral hemorrhage (SICH) is a devastating cerebrovascular disease that represents about 10–20% of all strokes and is characterized by high disability and mortality rates (13). Currently, there is no proven effective treatment for SICH due to the limited understanding of its pathogenesis. In particular, although it is widely accepted that bleeding occurring in the central part of the hematoma results in tissue destruction and irreversible damage, the mechanisms implicated in hematoma enlargement and perihematomal edema formation still remain a matter of debate. In fact, these two critical events are considered the major factors affecting outcome because together their effects could lead to clinical deterioration and death as a consequence of an increase in intracranial pressure (13). In this regard, a growing body of evidence suggests that a strong inflamma
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