Systemic High-Mobility Group Box-1: A Novel Predictive Biomarker for Cerebral Vasospasm in Aneurysmal Subarachnoid Hemorrhage*

Objectives: To investigate the release of proinflammatory damage-associated molecular pattern molecule “high-mobility group box-1” in the serum of patients after aneurysmal subarachnoid hemorrhage and its association with cerebral vasospasm. Design: Retrospective observational study. Setting: University hospital. Patients: Aneurysmal subarachnoid hemorrhage patients admitted within 24 hours of ictus. Interventions: Standard subarachnoid hemorrhage treatment after clipping or coiling of aneurysm. Measurements and Main Results: We enrolled 53 aneurysmal subarachnoid hemorrhage patients from which peripheral venous blood was withdrawn on days 1, 3, 5, 7, 9, 11, and 13 and once from the controls to obtain the serum. Serum high-mobility group box-1 concentration was quantified by enzyme-linked immunosorbent assay. Serum interleukin-6 and peripheral blood leukocytes were also determined over the first 2 weeks after subarachnoid hemorrhage. Patients’ data were recorded prospectively. Serum high-mobility group box-1 was significantly elevated in subarachnoid hemorrhage patients from day 1 to day 13 when compared with nonsubarachnoid hemorrhage patients (p

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