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Immune Characterization of Intracranial Aneurysms Using Noninvasive Endoluminal Biopsy With High-Dimensional
Joseph Antonios1, Batur Gultekin1, Brianna Theriault1
1Department of Neurosurgery, Yale School of Medicine, New Haven, CT.
Neurology
|September 25, 2025
Summary
Inflammation in intracranial aneurysms (IAs) is linked to rupture. Neutrophil-dominant inflammation is associated with IA growth and rupture, suggesting potential for immune-based therapies.
Area of Science:
- Neuroscience
- Immunology
- Cardiovascular Research
Background:
- Intracranial aneurysms (IAs) are dangerous arterial dilations.
- Inflammation plays a role in IA development and rupture.
- Immune mechanisms in IA stability are not well understood.
Purpose of the Study:
- To characterize the immune landscape of IAs.
- To identify immune signatures associated with IA stability, growth, and rupture.
- To utilize noninvasive endoluminal biopsy and single-cell phenotyping.
Main Methods:
- Prospective observational cohort study at Yale New Haven Hospital.
- Endoluminal biopsy samples collected during endovascular treatment.
- High-dimensional single-cell phenotyping via mass cytometry (cyTOF).
Main Results:
- Fifteen patients included; high sample viability.
- Unstable IAs showed neutrophil predominance and specific immune marker upregulation (CD38, HLA-DR, CCR7).
- Neutrophil-dominant inflammation (cyTOF group 1) associated with IA growth/rupture (p=0.01).
Conclusions:
- Noninvasive biopsy and cyTOF identify distinct IA immune signatures.
- Neutrophil-driven inflammation correlates with aneurysm instability.
- Findings may guide development of immune biomarkers and therapies for IA prevention.
