IL-23 and IL-17 are pro-inflammatory cytokines. IL-23 is secreted by activated macrophages and dendritic cells, while IL-17 by Th17 cells. Serum IL-23 and IL-17 are known to be elevated in numerous inflammatory diseases including neurodegenerative diseases. The role of serum IL-23 and IL-17 in aneurysmal subarachnoid hemorrhage (aSAH) has still not been investigated. The present work investigates the serum IL-23 and IL-17 levels and their association with post hemorrhagic complications and clinical outcome in patients with aSAH. METHODS:In this study, 80 patients with aSAH (Hunt and Hess grade I-V) were prospectively recruited. We enrolled 24 control patients with lumbar spinal stenosis. Peripheral venous blood was withdrawn from controls and from aSAH patients at day 1 and day 7, allowed to clot and centrifuged to obtain serum. Enzyme linked immunoassay kits were employed to quantify the serum levels of IL-23 and IL-17 by applying 50µL of serum samples. Post hemorrhagic complications and clinical outcome were documented prospectively from patient's hospital record. RESULTS:Serum IL-23 and IL-17 levels were significantly elevated in aSAH patients at day 1 and day 7 (n=80) as compared to control patients (n=24). Further analysis after dichotomy of patients who suffered from post hemorrhagic complications including cerebral vasospasm, chronic hydrocephalus, seizures, cerebral ischemia, delayed neurological deficits showed differential correlations with different post hemorrhagic complications (Table 1). Serum IL-23 and IL-17 levels did not correlate with clinical outcome. CONCLUSION:Serum IL-23 and IL-17 levels were elevated in patients with aSAH showing upregulation of IL-23/IL-17 inflammatory axis after aSAH. Serum IL-23 and IL-17 showed differential correlations with post hemorrhagic complications and no correlation with clinical outcome.

译文

:IL-23和IL-17是促炎性细胞因子。 IL-23由活化的巨噬细胞和树突状细胞分泌,而IL-17由Th17细胞分泌。已知血清IL-23和IL-17在包括神经退行性疾病在内的许多炎性疾病中均升高。血清IL-23和IL-17在动脉瘤性蛛网膜下腔出血(aSAH)中的作用尚未进行研究。本工作调查了aSAH患者的血清IL-23和IL-17水平及其与出血后并发症和临床结局的关系。
方法:在这项研究中,前瞻性招募了80例aSAH患者(Hunt和Hess I-V级)。我们招募了24名腰椎管狭窄的对照患者。在第1天和第7天从对照和aSAH患者中抽取外周静脉血,使其凝结并离心以获得血清。采用酶联免疫分析试剂盒,通过施加50µL血清样品定量IL-23和IL-17的血清水平。从患者的住院记录中前瞻性地记录了出血后并发症和临床结局。
结果:与对照组患者(n = 24)相比,aSAH患者在第1天和第7天的血清IL-23和IL-17水平显着升高(n = 80)。二分法对患有出血后并发症(包括脑血管痉挛,慢性脑积水,癫痫发作,脑缺血,迟发性神经功能缺损)的患者进行二分法手术后的进一步分析显示,不同出血后并发症的相关性不同(表1)。血清IL-23和IL-17水平与临床结果无关。
结论:aSAH患者血清IL-23和IL-17水平升高,显示aSAH后IL-23 / IL-17炎症轴上调。血清IL-23和IL-17与出血后并发症呈差异相关,与临床结局无相关性。

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