Different Kinetics of Serum ADAMTS13, GDF-15, and Neutrophil Gelatinase-Associated Lipocalin in the Early Phase of Aneurysmal Subarachnoid Hemorrhage

Peter Csecsei; Csaba Olah; Reka Varnai; Diana Simon; Szabina Erdo-Bonyar; Timea Berki; Mate Czabajszki; Laszlo Zavori; Attila Schwarcz; Tihamer Molnar

doi:10.3390/ijms241311005

Different Kinetics of Serum ADAMTS13, GDF-15, and Neutrophil Gelatinase-Associated Lipocalin in the Early Phase of Aneurysmal Subarachnoid Hemorrhage

Int J Mol Sci. 2023 Jul 2;24(13):11005. doi: 10.3390/ijms241311005.

Authors

Affiliations

¹ Department of Neurosurgery, Medical School, University of Pecs, 7624 Pecs, Hungary.
² Neurosurgical Unit, B.A.Z. County Hospital, 3526 Miskolc, Hungary.
³ Department of Primary Health Care, Medical School, University of Pecs, 7624 Pecs, Hungary.
⁴ Department of Immunology and Biotechnology, Medical School, University of Pecs, 7624 Pecs, Hungary.
⁵ Emergency Department, Saudi German Hospital, Dubai 391093, United Arab Emirates.
⁶ Department of Anaesthesiology and Intensive Care, Medical School, University of Pecs, 7624 Pecs, Hungary.

Abstract

Growth differentiation factor 15 (GDF-15), neutrophil gelatinase-associated lipocalin (NGAL), and ADAMTS13 have previously been implicated in the pathophysiological processes of SAH. In the present study, we aim to examine their role in the early period of SAH and their relationship to primary and secondary outcomes. Serum samples were collected at five time periods after SAH (at 24 h (D1), at 72 h (D3), at 120 h (D5), at 168 h (D7) and at 216 h (D9), post-admission) and) were measured by using MILLIPLEX Map Human Cardiovascular Disease (CVD) Magnetic Bead Panel 2. We included 150 patients with SAH and 30 healthy controls. GDF-15 levels at D1 to D9 were significantly associated with a 3-month unfavorable outcome. Based on the ROC analysis, in patients with a good clinical grade at admission (WFNS I-III), the GDF-15 value measured at time point D3 predicted a 3-month unfavorable outcome (cut-off value: 3.97 ng/mL, AUC:0.833, 95%CI: 0.728-0.938, sensitivity:73.7%, specificity:82.6%, p < 0.001). Univariate binary logistic regression analysis showed that serum NGAL levels at D1-D5 and ADAMTS13 levels at D7-D9 were associated with MVS following SAH. GDF-15 is an early indicator of a poor 3-month functional outcome even in patients with mild clinical conditions at admission.

Keywords: ADAMTS13; GDF-15; delayed cerebral ischemia; macrovascular vasospasm; neutrophil gelatinase-associated lipocalin; subarachnoid hemorrhage.

MeSH terms

ADAMTS13 Protein
Growth Differentiation Factor 15*
Hospitalization
Humans
Kinetics
Lipocalin-2
Subarachnoid Hemorrhage* / complications

Substances

Lipocalin-2
Growth Differentiation Factor 15
ADAMTS13 protein, human
ADAMTS13 Protein

Grants and funding

This project and the open access funding was supported by a grant (Faculty Research Fund (ÁOK-KA) János Szolcsányi research fund) from University of Pecs, Hungary.