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Increased CSF neopterin levels in subarachnoid hemorrhage
T Mathiesen1, D Fuchs, H Wachter
1Department of Neurosurgery, Karolinska Institute and Hospital, Stockholm, Sweden.
Journal of Neurosurgery
|July 1, 1990
Summary
Neopterin concentrations, a marker of immune activation, were elevated in patients with subarachnoid hemorrhage (SAH). This immune response was most pronounced in cerebrospinal fluid (CSF) and linked to delayed cerebral ischemia.
Area of Science:
- Neuroscience
- Immunology
- Clinical Medicine
Background:
- Subarachnoid hemorrhage (SAH) is a critical neurological condition.
- Immune system activation is increasingly recognized in the pathophysiology of SAH.
- Neopterin is a biomarker indicative of T-cell and macrophage activation.
Purpose of the Study:
- To investigate neopterin concentrations in serum and cerebrospinal fluid (CSF) of SAH patients.
- To correlate neopterin levels with clinical outcomes, particularly delayed cerebral ischemia.
Main Methods:
- Serum and CSF samples were collected from 14 patients with SAH.
- Neopterin concentrations were measured in these samples.
- Levels were analyzed over time and in relation to clinical events.
Main Results:
- Neopterin concentrations were elevated in both serum and CSF following SAH.
- A significant increase in CSF neopterin was observed between Days 1-3 and Days 6-9 post-SAH.
- The highest neopterin levels were found in patients who developed delayed cerebral ischemia.
Conclusions:
- SAH triggers a systemic and central nervous system immune response, indicated by elevated neopterin.
- The marked increase in CSF neopterin suggests significant T-cell activation within the CNS after SAH.
- Neopterin levels may serve as a prognostic marker for complications like delayed cerebral ischemia in SAH.