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Activation of Cytotoxic Natural Killer Cells after Aneurysmal Subarachnoid Haemorrhage.
World Neurosurg. 2017 Mar 16;:
Authors: Spitzer D, Johanna Spitzer N, Deininger M, Rainer Wirtz C, König R, Burster T, Kapapa T
Abstract
OBJECTIVE: Cell-mediated inflammation is critical in development of cerebrovascular complications after aneurysmal subarachnoid haemorrhage (aSAH). We analysed the course for activated CD16(bright)CD56(dim) cytotoxic NKCSF cells (NK) in cerebrospinal fluid (CSF) of 15 patients.
METHODS: Patients were classified by occurrence of cerebral vasospasm and delayed cerebral ischemia. NK were monitored by flow cytometry between day 1 and 14 after haemorrhage.
RESULTS: 12 (80%) patients developed CV with a mean day of detection at 3.9±1.6. In those cell count for NK increased from 1.40±1.42 cells/μl on day 1 to a peak of 11.66±11.56 cells/μl on day 6.1±2.9 (p=0.001). An increase of mean CBFV in TCD from 71.33±12.93 cm/sec. to 166.20±20.19 cm/sec. (p<0.01) and an increase in number of vascular axes affected by CV was detected (p<0.01). In patients with grade 3 CV (n=4, 33.3%) activated NK counts were significantly higher than in non-CV patients (23.18±13.92 cells/μl versus 0.02±0.01 cells/μl; p=0.029). NK counts were significantly different between patients with grade 1 and grade 3 CV (p=0.04). Non-CV patients who demonstrated low NK counts achieved better functional outcome (GOS 4.6±0.6) at discharge than patients with CV grade 2 (GOS 3.3±0.5) and CV grade 3 (GOS 2.3±0.5) who demonstrated elevated NKC counts (CV grade 0 versus CV grade 2, p=0.048; CV grade 0 versus CV grade 3, p=0.001). Activated CD16(bright)CD56(dim) cytotoxic NKCSF cell counts revealed a mean maximum (14.15±12.21 cells/μl) when DCI occurred.
CONCLUSION: The increase of activated CD16(bright)CD56(dim) cytotoxic NK cells in CSF after aSAH suggests an increased risk of CV and DCI.
PMID: 28323187 [PubMed - as supplied by publisher]
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