Elevated serum nuclear factor erythroid 2-related factor 2 levels contribute to a poor prognosis after acute supratentorial intracerebral hemorrhage: A prospective cohort study
ObjectiveNuclear factor erythroid 2-related factor 2 (Nrf2) is a key transcriptional factor for antioxidant response element-regulated genes. The purpose of this study was to assess the prognostic role of serum Nrf2 in intracerebral hemorrhage (ICH).Materials and methodsIn this prospective observati...
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Frontiers Media S.A.
2022-10-01
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| Series: | Frontiers in Aging Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnagi.2022.1014472/full |
| _version_ | 1811235058643632128 |
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| author | Chuan-Liu Wang Xin-Jiang Yan Cheng-Liang Zhang Yan-Wen Xu |
| author_facet | Chuan-Liu Wang Xin-Jiang Yan Cheng-Liang Zhang Yan-Wen Xu |
| author_sort | Chuan-Liu Wang |
| collection | DOAJ |
| description | ObjectiveNuclear factor erythroid 2-related factor 2 (Nrf2) is a key transcriptional factor for antioxidant response element-regulated genes. The purpose of this study was to assess the prognostic role of serum Nrf2 in intracerebral hemorrhage (ICH).Materials and methodsIn this prospective observational study, serum Nrf2 levels of 115 acute supratentorial ICH patients and 115 controls were gaged. Early neurologic deterioration (END) was defined as an increase of four or greater points in National Institutes of Health Stroke Scale (NIHSS) score or death at post-stroke 24 h. A poor outcome was referred to as the post-stroke 90-day modified Rankin scale (mRS) score of 3–6. END and a poor outcome were considered as the two prognostic parameters.ResultsAs compared to controls, serum Nrf2 levels of patients were substantially elevated (P < 0.001), with its levels increasing during the 6-h period immediately, peaking in 12–18 h, plateauing at 18–24 h, and decreasing gradually thereafter (P < 0.05). Serum Nrf2 levels of patients were independently correlated with NIHSS score (t = 3.033; P = 0.003) and hematoma volume (t = 3.210; P = 0.002), independently predicted END (odds ratio 1.125; 95% confidence interval 1.027–1.232; P = 0.011) and poor outcome (odds ratio 1.217; 95% confidence interval 1.067–1.387; P = 0.013), as well as efficiently distinguished END (area under curve 0.771; 95% confidence interval 0.666–0.877; P < 0.001) and poor outcome (area under curve 0.803; 95% confidence interval 0.725–0.882; P < 0.001). Its predictive ability was equivalent to those of NIHSS score and hematoma volume (both P > 0.05), and it also significantly improved their predictive abilities under receiver operating characteristic (ROC) curve (all P < 0.05).ConclusionElevated serum Nrf2 levels are closely correlated with severity, END, and 90-day poor outcome following ICH. Hence, Nrf2 may play an important role in acute brain injury after ICH, and serum Nrf2 may have the potential to serve as a prognostic biomarker of ICH. |
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| institution | Directory Open Access Journal |
| issn | 1663-4365 |
| language | English |
| last_indexed | 2024-04-12T11:45:46Z |
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| spelling | doaj.art-0e02c6d567ed475cb28526af7be7efc92022-12-22T03:34:20ZengFrontiers Media S.A.Frontiers in Aging Neuroscience1663-43652022-10-011410.3389/fnagi.2022.10144721014472Elevated serum nuclear factor erythroid 2-related factor 2 levels contribute to a poor prognosis after acute supratentorial intracerebral hemorrhage: A prospective cohort studyChuan-Liu Wang0Xin-Jiang Yan1Cheng-Liang Zhang2Yan-Wen Xu3Department of Neurology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, Zhejiang, ChinaDepartment of Neurosurgery, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, Zhejiang, ChinaDepartment of Neurology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, Zhejiang, ChinaDepartment of Neurology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, Zhejiang, ChinaObjectiveNuclear factor erythroid 2-related factor 2 (Nrf2) is a key transcriptional factor for antioxidant response element-regulated genes. The purpose of this study was to assess the prognostic role of serum Nrf2 in intracerebral hemorrhage (ICH).Materials and methodsIn this prospective observational study, serum Nrf2 levels of 115 acute supratentorial ICH patients and 115 controls were gaged. Early neurologic deterioration (END) was defined as an increase of four or greater points in National Institutes of Health Stroke Scale (NIHSS) score or death at post-stroke 24 h. A poor outcome was referred to as the post-stroke 90-day modified Rankin scale (mRS) score of 3–6. END and a poor outcome were considered as the two prognostic parameters.ResultsAs compared to controls, serum Nrf2 levels of patients were substantially elevated (P < 0.001), with its levels increasing during the 6-h period immediately, peaking in 12–18 h, plateauing at 18–24 h, and decreasing gradually thereafter (P < 0.05). Serum Nrf2 levels of patients were independently correlated with NIHSS score (t = 3.033; P = 0.003) and hematoma volume (t = 3.210; P = 0.002), independently predicted END (odds ratio 1.125; 95% confidence interval 1.027–1.232; P = 0.011) and poor outcome (odds ratio 1.217; 95% confidence interval 1.067–1.387; P = 0.013), as well as efficiently distinguished END (area under curve 0.771; 95% confidence interval 0.666–0.877; P < 0.001) and poor outcome (area under curve 0.803; 95% confidence interval 0.725–0.882; P < 0.001). Its predictive ability was equivalent to those of NIHSS score and hematoma volume (both P > 0.05), and it also significantly improved their predictive abilities under receiver operating characteristic (ROC) curve (all P < 0.05).ConclusionElevated serum Nrf2 levels are closely correlated with severity, END, and 90-day poor outcome following ICH. Hence, Nrf2 may play an important role in acute brain injury after ICH, and serum Nrf2 may have the potential to serve as a prognostic biomarker of ICH.https://www.frontiersin.org/articles/10.3389/fnagi.2022.1014472/fullnuclear factor-erythroid 2-related factor 2intracerebral hemorrhageearly neurologic deteriorationoutcomeseveritymechanism |
| spellingShingle | Chuan-Liu Wang Xin-Jiang Yan Cheng-Liang Zhang Yan-Wen Xu Elevated serum nuclear factor erythroid 2-related factor 2 levels contribute to a poor prognosis after acute supratentorial intracerebral hemorrhage: A prospective cohort study Frontiers in Aging Neuroscience nuclear factor-erythroid 2-related factor 2 intracerebral hemorrhage early neurologic deterioration outcome severity mechanism |
| title | Elevated serum nuclear factor erythroid 2-related factor 2 levels contribute to a poor prognosis after acute supratentorial intracerebral hemorrhage: A prospective cohort study |
| title_full | Elevated serum nuclear factor erythroid 2-related factor 2 levels contribute to a poor prognosis after acute supratentorial intracerebral hemorrhage: A prospective cohort study |
| title_fullStr | Elevated serum nuclear factor erythroid 2-related factor 2 levels contribute to a poor prognosis after acute supratentorial intracerebral hemorrhage: A prospective cohort study |
| title_full_unstemmed | Elevated serum nuclear factor erythroid 2-related factor 2 levels contribute to a poor prognosis after acute supratentorial intracerebral hemorrhage: A prospective cohort study |
| title_short | Elevated serum nuclear factor erythroid 2-related factor 2 levels contribute to a poor prognosis after acute supratentorial intracerebral hemorrhage: A prospective cohort study |
| title_sort | elevated serum nuclear factor erythroid 2 related factor 2 levels contribute to a poor prognosis after acute supratentorial intracerebral hemorrhage a prospective cohort study |
| topic | nuclear factor-erythroid 2-related factor 2 intracerebral hemorrhage early neurologic deterioration outcome severity mechanism |
| url | https://www.frontiersin.org/articles/10.3389/fnagi.2022.1014472/full |
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