Alpha 1-antitrypsin activity in subarachnoid hemorrhage

Area of Science:

• Biochemistry
• Vascular Biology
• Neurology

Background:

• Protease-inhibitor imbalances may contribute to aneurysm rupture.
• Alpha 1-antitrypsin (alpha 1-AT) is a key inhibitor of elastase, involved in collagen metabolism.
• Investigating alpha 1-AT activity in subarachnoid hemorrhage (SAH) is crucial for understanding aneurysm rupture.

Purpose of the Study:

• To investigate alterations in alpha 1-antitrypsin (alpha 1-AT) activity in patients with subarachnoid hemorrhage (SAH).
• To determine if alpha 1-AT levels and collagenase inhibitory capacity (CIC) differ between SAH patients and control groups.

Main Methods:

• Analyzed serum samples from 27 SAH patients, 5 unruptured intracranial aneurysm cases, 15 unruptured aortic aneurysm cases, and 10 non-vascular CNS disease controls.
• Measured alpha 1-AT levels using an immunoturbidimetric method.
• Assessed collagenase inhibitory percentage capacity (CIC) and its relationship with alpha 1-AT.

Main Results:

• Serum alpha 1-AT levels were significantly lower in SAH patients admitted within 72 hours compared to those admitted later.
• The linear relationship between alpha 1-AT and CIC varied across subgroups.
• Alpha 1-AT CIC was significantly lower in SAH patients compared to controls and unruptured aneurysm groups (p = 0.0001).

Conclusions:

• Alpha 1-antitrypsin (alpha 1-AT) activity is significantly reduced in patients with subarachnoid hemorrhage (SAH).
• Lowered alpha 1-AT CIC in SAH patients suggests a role in aneurysm rupture pathogenesis.
• These findings highlight alpha 1-AT as a potential biomarker in SAH and aneurysm rupture.