Dimethylarginines in patients with intracerebral hemorrhage: association with outcome, hematoma enlargement, and edema
Abstract Background Asymmetric dimethylarginine (ADMA)––the most potent endogenous NO-synthase inhibitor, has been regarded as mediator of endothelial dysfunction and oxidative stress. Considering experimental data, levels of ADMA and its structural isomer symmetric dimethylarginine (SDMA) might be...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2017-12-01
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| Series: | Journal of Neuroinflammation |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12974-017-1016-1 |
| _version_ | 1819044466472779776 |
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| author | Hans Worthmann Na Li Jens Martens-Lobenhoffer Meike Dirks Ramona Schuppner Ralf Lichtinghagen Jan T. Kielstein Peter Raab Heinrich Lanfermann Stefanie M. Bode-Böger Karin Weissenborn |
| author_facet | Hans Worthmann Na Li Jens Martens-Lobenhoffer Meike Dirks Ramona Schuppner Ralf Lichtinghagen Jan T. Kielstein Peter Raab Heinrich Lanfermann Stefanie M. Bode-Böger Karin Weissenborn |
| author_sort | Hans Worthmann |
| collection | DOAJ |
| description | Abstract Background Asymmetric dimethylarginine (ADMA)––the most potent endogenous NO-synthase inhibitor, has been regarded as mediator of endothelial dysfunction and oxidative stress. Considering experimental data, levels of ADMA and its structural isomer symmetric dimethylarginine (SDMA) might be elevated after intracerebral hemorrhage (ICH) and associated with clinical outcome and secondary brain injury. Methods Blood samples from 20 patients with acute ICH were taken at ≤ 24 h and 3 and 7 days after the event. Nine patients had favorable (modified Rankin Scale (mRS) at 90 days 0–2) outcome, and 11 patients unfavorable outcome (mRS 3–6). Patients’ serum ADMA, SDMA, and L-arginine levels were determined by high-performance liquid chromatography–tandem mass spectrometry. Levels were compared to those of 30 control subjects without ICH. For further analysis, patients were grouped according to outcome, hematoma and perihematomal edema volumes, occurrence of hematoma enlargement, and cytotoxic edema as measured by computed tomography and serial magnetic resonance imaging. Results Levels of ADMA––but not SDMA and L-arginine––were elevated in ICH patients compared to controls (binary logistic regression analysis: ADMA ≤ 24 h, p = 0.003; 3 days p = 0.005; 7 days p = 0.004). If patients were grouped according to outcome, dimethylarginines were increased in patients with unfavorable outcome. The binary logistic regression analysis confirmed an association of SDMA levels ≤ 24 h (p = 0.048) and at 3 days (p = 0.028) with unfavorable outcome. ADMA ≤ 24 h was increased in patients with hematoma enlargement (p = 0.003), while SDMA ≤ 24 h was increased in patients with large hematoma (p = 0.029) and perihematomal edema volume (p = 0.023). Conclusions Our data demonstrate an association between dimethylarginines and outcome of ICH. However, further studies are needed to confirm this relationship and elucidate the mechanisms behind. |
| first_indexed | 2024-12-21T10:13:08Z |
| format | Article |
| id | doaj.art-c692472f51d548178903d50bb1e4a268 |
| institution | Directory Open Access Journal |
| issn | 1742-2094 |
| language | English |
| last_indexed | 2024-12-21T10:13:08Z |
| publishDate | 2017-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Neuroinflammation |
| spelling | doaj.art-c692472f51d548178903d50bb1e4a2682022-12-21T19:07:39ZengBMCJournal of Neuroinflammation1742-20942017-12-011411810.1186/s12974-017-1016-1Dimethylarginines in patients with intracerebral hemorrhage: association with outcome, hematoma enlargement, and edemaHans Worthmann0Na Li1Jens Martens-Lobenhoffer2Meike Dirks3Ramona Schuppner4Ralf Lichtinghagen5Jan T. Kielstein6Peter Raab7Heinrich Lanfermann8Stefanie M. Bode-Böger9Karin Weissenborn10Department of Neurology, Hannover Medical SchoolDepartment of Neurology, Hannover Medical SchoolDepartment of Clinical Pharmacology, Otto-von-Guericke-University of Magdeburg, University HospitalDepartment of Neurology, Hannover Medical SchoolDepartment of Neurology, Hannover Medical SchoolDepartment of Clinical Chemistry, Hannover Medical SchoolDepartment of Nephrology and Hypertension, Hannover Medical SchoolInstitute of Diagnostic and Interventional Neuroradiology, Hannover Medical SchoolInstitute of Diagnostic and Interventional Neuroradiology, Hannover Medical SchoolDepartment of Clinical Pharmacology, Otto-von-Guericke-University of Magdeburg, University HospitalDepartment of Neurology, Hannover Medical SchoolAbstract Background Asymmetric dimethylarginine (ADMA)––the most potent endogenous NO-synthase inhibitor, has been regarded as mediator of endothelial dysfunction and oxidative stress. Considering experimental data, levels of ADMA and its structural isomer symmetric dimethylarginine (SDMA) might be elevated after intracerebral hemorrhage (ICH) and associated with clinical outcome and secondary brain injury. Methods Blood samples from 20 patients with acute ICH were taken at ≤ 24 h and 3 and 7 days after the event. Nine patients had favorable (modified Rankin Scale (mRS) at 90 days 0–2) outcome, and 11 patients unfavorable outcome (mRS 3–6). Patients’ serum ADMA, SDMA, and L-arginine levels were determined by high-performance liquid chromatography–tandem mass spectrometry. Levels were compared to those of 30 control subjects without ICH. For further analysis, patients were grouped according to outcome, hematoma and perihematomal edema volumes, occurrence of hematoma enlargement, and cytotoxic edema as measured by computed tomography and serial magnetic resonance imaging. Results Levels of ADMA––but not SDMA and L-arginine––were elevated in ICH patients compared to controls (binary logistic regression analysis: ADMA ≤ 24 h, p = 0.003; 3 days p = 0.005; 7 days p = 0.004). If patients were grouped according to outcome, dimethylarginines were increased in patients with unfavorable outcome. The binary logistic regression analysis confirmed an association of SDMA levels ≤ 24 h (p = 0.048) and at 3 days (p = 0.028) with unfavorable outcome. ADMA ≤ 24 h was increased in patients with hematoma enlargement (p = 0.003), while SDMA ≤ 24 h was increased in patients with large hematoma (p = 0.029) and perihematomal edema volume (p = 0.023). Conclusions Our data demonstrate an association between dimethylarginines and outcome of ICH. However, further studies are needed to confirm this relationship and elucidate the mechanisms behind.http://link.springer.com/article/10.1186/s12974-017-1016-1ADMASDMAIntracerebral hemorrhageOutcomeHematoma enlargementEdema |
| spellingShingle | Hans Worthmann Na Li Jens Martens-Lobenhoffer Meike Dirks Ramona Schuppner Ralf Lichtinghagen Jan T. Kielstein Peter Raab Heinrich Lanfermann Stefanie M. Bode-Böger Karin Weissenborn Dimethylarginines in patients with intracerebral hemorrhage: association with outcome, hematoma enlargement, and edema Journal of Neuroinflammation ADMA SDMA Intracerebral hemorrhage Outcome Hematoma enlargement Edema |
| title | Dimethylarginines in patients with intracerebral hemorrhage: association with outcome, hematoma enlargement, and edema |
| title_full | Dimethylarginines in patients with intracerebral hemorrhage: association with outcome, hematoma enlargement, and edema |
| title_fullStr | Dimethylarginines in patients with intracerebral hemorrhage: association with outcome, hematoma enlargement, and edema |
| title_full_unstemmed | Dimethylarginines in patients with intracerebral hemorrhage: association with outcome, hematoma enlargement, and edema |
| title_short | Dimethylarginines in patients with intracerebral hemorrhage: association with outcome, hematoma enlargement, and edema |
| title_sort | dimethylarginines in patients with intracerebral hemorrhage association with outcome hematoma enlargement and edema |
| topic | ADMA SDMA Intracerebral hemorrhage Outcome Hematoma enlargement Edema |
| url | http://link.springer.com/article/10.1186/s12974-017-1016-1 |
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