Background: 

This pilot study investigated plasma concentrations of hyaluronan, heparan sulfate, and syndecan-1 as possible biomarkers for glycocalyx integrity after aneurysmal subarachnoid hemorrhage (aSAH).

Methods: 

Daily blood samples for biomarker assay were obtained in aSAH patients on the intensive care unit stay and compared with samples from a historic cohort of 40 healthy controls. In post hoc subgroup analyses in patients with and without cerebral vasospasm, we explored the influence of aSAH-related cerebral vasospasm on biomarker levels.

Results: 

A total of 18 aSAH patients and 40 historic controls were included in the study. Median (interquartile range) plasma levels of hyaluronan were higher in aSAH patients compared with controls (131 [84 to 179] vs. 92 [82 to 98] ng/mL, respectively; P=0.009), whereas heparan sulfate (mean±SD: 754±428 vs. 1329±316 ng/mL; P<0.001) and syndecan-1 (median: 23 [17 to 36] vs. 30 [23 to 52] ng/mL; P=0.02) levels were lower. Patients who developed vasospasm had significantly higher median hyaluronan concentrations at day 7 (206 [165 to 288] vs. 133 [108 to 164] ng/mL, respectively; P=0.009) and at day of first vasospasm detection (203 [155 to 231] vs. 133 [108 to 164] ng/mL, respectively; P=0.01) compared with those without vasospasm. Heparan sulfate and syndecan-1 concentrations were similar in patients with and without vasospasm.

Conclusions: 

The increased plasma concentrations of hyaluronan after aSAH suggest selective shedding of this component of the glycocalyx. Increased levels of hyaluronan in patients with cerebral vasospasm, underlines a potential role for hyaluronan in vasospasm processes.

中文翻译：

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透明质酸在动脉瘤性蛛网膜下腔出血和脑血管痉挛中的释放：一项表明内皮糖萼脱落的初步研究

背景： 

该初步研究调查了透明质酸、硫酸乙酰肝素和聚糖-1 的血浆浓度，作为动脉瘤性蛛网膜下腔出血 (aSAH) 后糖萼完整性的可能生物标志物。

方法： 

在重症监护室住院的 aSAH 患者中获取用于生物标志物测定的每日血液样本，并与来自 40 名健康对照的历史队列的样本进行比较。在有和没有脑血管痉挛患者的事后亚组分析中，我们探讨了 aSAH 相关脑血管痉挛对生物标志物水平的影响。

结果： 

该研究共包括 18 名 aSAH 患者和 40 名历史对照。与对照组相比，aSAH 患者的乙酰透明质酸血浆中位水平（四分位距）高于对照组（分别为 131 [84 至 179] 和 92 [82 至 98] ng/mL；P = 0.009），而硫酸乙酰肝素（平均值± SD ：754±428 与 1329±316 ng/mL；P <0.001）和 syndecan-1（中值：23 [17 至 36] 与 30 [23 至 52] ng/mL；P =0.02）水平较低。出现血管痉挛的患者在第 7 天（分别为 206 [165 至 288] 与 133 [108 至 164] ng/mL；P =0.009）和首次检测到血管痉挛的当天（203 [155 至 288] 和 133 [108 至 164] ng/ mL； 231] 与 133 [108 至 164] ng/mL，分别；P=0.01) 与那些没有血管痉挛的人相比。有和没有血管痉挛的患者的硫酸乙酰肝素和 syndecan-1 浓度相似。

结论： 

aSAH 后乙酰透明质酸的血浆浓度增加表明该糖萼成分的选择性脱落。脑血管痉挛患者的乙酰透明质酸水平升高，强调了乙酰透明质酸在血管痉挛过程中的潜在作用。