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Elevated systemic chemokine CCL5 is a predictive biomarker for post SAH complications and clinical outcome after aneurysmal subarachnoid hemorrhage (aSAH)
EANS Academy. Muhammad S. Sep 27, 2019; 275930; EP01081
Assoc. Prof. Sajjad Muhammad
Assoc. Prof. Sajjad Muhammad

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Abstract
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Background: Aneurysmal subarachnoid hemorrhage (aSAH) has the poorest outcomes among all stroke subtypes. Accumulating evidence suggests a critical role of inflammation in aSAH and post-aSAH complications. Chemokines play an important role in inflammation via leukocyte chemotaxis. Chemokine C-C motif ligand 5 (CCL5) is a potent pro-inflammatory chemokine shown to be upregulated in preclinical SAH studies. However, detailed clinical investigations are still lacking.
Objective: The current study investigated the role of systemic CCL5/RANTES after aSAH. The secondary aim was to determine associations between different post-aSAH complications and clinical outcome with systemic CCL5 levels.
Methods: We prospectively recruited 80 aSAH and 24 control patients. Peripheral venous blood was collected in serum gel tubes and centrifuged to harvest the serum, which was immediately frozen at -80°C until analysis. Serum CCL5 levels were quantified using enzyme-linked immunoassays. Age, gender, post-aSAH complications, aneurysm treatment, and clinical outcome (modified Rankin scale [mRS] and Glasgow outcome scale[GOS]) were retrieved from patient records.
Results: Serum CCL5 levels were significantly elevated after aSAH on days 1 and 7 in comparison with control patients. Dichotomization of patients to good (mRS 0-2 or GOS 4-5) and poor (mRS 3-6 or GOS 1-3) clinical outcomes showed that serum CCL5 levels were significantly higher in patients with good clinical outcome at discharge. Interestingly, CCL5 levels were significantly lower on day 7 in aSAH patients with intracerebral bleeding, chronic hydrocephalus, and pneumonia. Serum CCL5 levels on day 7 showed a positive correlation with clinical outcome (mRS and GOS).
Conclusion: Serum CCL5 levels were elevated during early and delayed brain injury phases after aSAH. Serum CCL5 levels on day 7 were independently associated with clinical outcome (mRS) at discharge.
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