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Haemoglobin scavenging after subarachnoid haemorrhage

Haemoglobin scavenging after subarachnoid haemorrhage
Haemoglobin scavenging after subarachnoid haemorrhage
Rapid and effective clearance of cell-free haemoglobin after subarachnoid haemorrhage (SAH) is important to prevent vasospasm and neurotoxicity and improve long-term outcome. Haemoglobin is avidly bound by haptoglobin, and the complex is cleared by CD163 expressed on the membrane surface of macrophages. We studied the kinetics of haemoglobin and haptoglobin in cerebrospinal fluid after SAH. We show that haemoglobin levels rise gradually after SAH. Haptoglobin levels rise acutely with aneurysmal rupture as a result of injection of blood into the subarachnoid space. Although levels decline as haemoglobin scavenging occurs, complete depletion of haptoglobin does not occur and levels start rising again, indicating saturation of CD163 sites available for haptoglobin-haemoglobin clearance. In a preliminary neuropathological study we demonstrate that meningeal CD163 expression is upregulated after SAH, in keeping with a proinflammatory state. However, loss of CD163 occurs in meningeal areas with overlying blood compared with areas without overlying blood. Becauses ADAM17 is the enzyme responsible for shedding membrane-bound CD163, its inhibition may be a potential therapeutic strategy after SAH.
subarachnoid haemorrhage, vasospasm, haemoglobin, haptoglobin, delayed neurological deficit
0065-1419
51-54
Durnford, A.
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Dunbar, J.
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Galea, J.
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Bulters, D.
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Nicoll, J.A.R.
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Boche, D.
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Galea, I.
66209a2f-f7e6-4d63-afe4-e9299f156f0b
Durnford, A.
e915b595-7dee-40c6-901d-c9845a7e4f54
Dunbar, J.
ff94d10d-6d90-449a-b4b8-90a8308b71cd
Galea, J.
f09277b6-7179-493e-9d65-e7f67e65a2a5
Bulters, D.
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Nicoll, J.A.R.
88c0685f-000e-4eb7-8f72-f36b4985e8ed
Boche, D.
bdcca10e-6302-4dd0-919f-67218f7e0d61
Galea, I.
66209a2f-f7e6-4d63-afe4-e9299f156f0b

Durnford, A., Dunbar, J., Galea, J., Bulters, D., Nicoll, J.A.R., Boche, D. and Galea, I. (2015) Haemoglobin scavenging after subarachnoid haemorrhage. Acta Neurochirurgica Supplement, 120, 51-54. (doi:10.1007/978-3-319-04981-6_9). (PMID:25366599)

Record type: Article

Abstract

Rapid and effective clearance of cell-free haemoglobin after subarachnoid haemorrhage (SAH) is important to prevent vasospasm and neurotoxicity and improve long-term outcome. Haemoglobin is avidly bound by haptoglobin, and the complex is cleared by CD163 expressed on the membrane surface of macrophages. We studied the kinetics of haemoglobin and haptoglobin in cerebrospinal fluid after SAH. We show that haemoglobin levels rise gradually after SAH. Haptoglobin levels rise acutely with aneurysmal rupture as a result of injection of blood into the subarachnoid space. Although levels decline as haemoglobin scavenging occurs, complete depletion of haptoglobin does not occur and levels start rising again, indicating saturation of CD163 sites available for haptoglobin-haemoglobin clearance. In a preliminary neuropathological study we demonstrate that meningeal CD163 expression is upregulated after SAH, in keeping with a proinflammatory state. However, loss of CD163 occurs in meningeal areas with overlying blood compared with areas without overlying blood. Becauses ADAM17 is the enzyme responsible for shedding membrane-bound CD163, its inhibition may be a potential therapeutic strategy after SAH.

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__soton.ac.uk_ude_personalfiles_users_ig1_mydocuments_Clinical Neurosciences_Subarachnoid haemorrhage_Vasospasm2013_Acta Neurochir supplement_Submission_Durnford A et al 2015.pdf - Accepted Manuscript
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Published date: 2 August 2015
Keywords: subarachnoid haemorrhage, vasospasm, haemoglobin, haptoglobin, delayed neurological deficit
Organisations: Clinical & Experimental Sciences

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Local EPrints ID: 384272
URI: https://eprints.soton.ac.uk/id/eprint/384272
ISSN: 0065-1419
PURE UUID: 8f36b4fd-b39c-4d83-909f-8090279b12a6
ORCID for J.A.R. Nicoll: ORCID iD orcid.org/0000-0002-9444-7246
ORCID for D. Boche: ORCID iD orcid.org/0000-0002-5884-130X
ORCID for I. Galea: ORCID iD orcid.org/0000-0002-1268-5102

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Date deposited: 02 Dec 2015 17:01
Last modified: 19 Jul 2019 01:04

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