Clusterin as a potential marker of brain ischemia-reperfusion injury in patients undergoing carotid endarterectomy

Ups J Med Sci. 2019 Aug;124(3):193-198. doi: 10.1080/03009734.2019.1646359. Epub 2019 Aug 28.

Abstract

Introduction: Carotid endarterectomy (CEA) is a surgical procedure used in the prevention of ischemic stroke. However, this procedure can cause complications of ischemia-reperfusion injury to the brain. Clusterin (CLU) is a cytoprotective chaperone protein that is released from neurons in response to various neurological injuries. The objective of the study was to report the changes in serum CLU concentrations of patients undergoing CEA. Materials and methods: The study involved 25 patients with severe internal carotid artery stenosis. Serum samples were taken from patients at three different times: within 24 hours preoperatively to CEA, 12 hours postoperatively, and 48 hours postoperatively. Serum CLU concentrations were measured using a commercially available enzyme-linked immunosorbent assay. Results: When compared to concentrations preoperatively, the serum CLU concentration initially decreased during the 12 hours following CEA. However, 48 hours following the procedure there was an increase in the CLU concentration. After statistical analysis, differences were detected in serum CLU concentration between all three recorded measurements (P < 0.05). Conclusion: Data from our study indicate that serum CLU concentrations are affected after CEA. We hypothesize that serum CLU concentrations may depend on brain ischemia-reperfusion injury following this surgical procedure.

Keywords: Brain injury; carotid endarterectomy; clusterin; potential markers.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Biomarkers / blood
  • Brain Ischemia / blood*
  • Brain Ischemia / prevention & control
  • Carotid Stenosis / blood
  • Carotid Stenosis / diagnostic imaging
  • Carotid Stenosis / surgery*
  • Clusterin / blood*
  • Cohort Studies
  • Endarterectomy, Carotid / adverse effects
  • Endarterectomy, Carotid / methods*
  • Enzyme-Linked Immunosorbent Assay / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Postoperative Care / methods
  • Preoperative Care / methods
  • Prospective Studies
  • Reperfusion Injury / blood*
  • Reperfusion Injury / prevention & control
  • Reproducibility of Results
  • Risk Assessment
  • Severity of Illness Index
  • Time Factors
  • Treatment Outcome
  • Ultrasonography, Doppler / methods

Substances

  • Biomarkers
  • CLU protein, human
  • Clusterin

Grants and funding

The study was supported by the Foundation for the Development of Vascular Surgery at the Department of Vascular Surgery and Angiology, Medical University of Lublin, Lublin, Poland.