CSF vs. Serum Nitric Oxide Metabolite Ratios in SAH Outcomes

| Posted in: Science

Journal name: The Malaysian Journal of Medical Sciences
Original article title: Ratio of Nitric Oxide Metabolite Levels in Cerebrospinal Fluid and Serum, and Their Correlation with Severity and Outcome in Patients with Subarachnoid Haemorrhage
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Original source:

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Author:

Giat Seng KHO, Regunath KANDASAMY, Mohamad Adam BUJANG, Mummedy SWAMMY, Muzaimi MUSTAPHA, Jafri Malin ABDULLAH


The Malaysian Journal of Medical Sciences:

(A peer-reviewed, open-access journal)

Full text available for: Ratio of Nitric Oxide Metabolite Levels in Cerebrospinal Fluid and Serum, and Their Correlation with Severity and Outcome in Patients with Subarachnoid Haemorrhage

Year: 2021 | Doi: 10.21315/mjms2021.28.6.5

Copyright (license): CC BY 4.0


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Summary of article contents:

Introduction

Subarachnoid hemorrhage (SAH) is a critical condition characterized by the extravasation of blood into the space between the pia and arachnoid layers of the brain, often due to the rupture of an intracranial aneurysm. This condition accounts for a significant percentage of strokes and is associated with severe morbidity and mortality. Despite the development of various grading scales such as the World Federation of Neurosurgeons Score (WFNS), accurately predicting clinical outcomes post-SAH remains challenging. Nitric oxide (NO) and its metabolites, particularly nitric oxide metabolites (NOx), have been investigated as potential biomarkers to assess the severity and prognosis of SAH patients.

The Role of NOx as a Biomarker in SAH

One significant finding of the study is the correlation of NOx levels in cerebrospinal fluid (CSF) and serum with patient outcomes in SAH. The research demonstrated that elevated NOx levels in both CSF and serum, alongside a reduction in the CSF-to-serum NOx ratio, were associated with greater severity of SAH, the occurrence of vasospasm, and poor clinical outcomes. Specifically, higher ratios of NOx in CSF compared to serum were linked to better outcomes, suggesting that the CSF-to-serum NOx ratio could serve as a valuable biomarker for assessing the prognosis of SAH patients. This finding highlights the complexity of the relationship between NOx levels and the physiological processes following SAH, underscoring the need for further investigation into the biological mechanisms governing these correlations.

Conclusion

In conclusion, the study supports the potential application of NOx levels in both CSF and serum, particularly the CSF-to-serum ratio, as biomarkers for evaluating the severity and prognosis of patients experiencing SAH. The findings emphasize the importance of understanding the dynamics of NOx in relation to clinical outcomes, with elevated levels suggesting more severe conditions. As further research is needed to validate these results and expand on the mechanisms involved, the integration of NOx measurements into clinical practice could enhance the predictive capabilities for patient outcomes in SAH, aiding in more effective management strategies.

FAQ section (important questions/answers):

What is the aim of this study on nitric oxide?

This study aims to investigate the levels of nitric oxide metabolites (NOx) in cerebrospinal fluid (CSF) and serum of patients with spontaneous subarachnoid hemorrhage (SAH) and analyze their associations with clinical outcomes.

How was the study on nitric oxide conducted?

A prospective cohort study was conducted over two years, collecting CSF and serum NOx levels in patients with radiologically confirmed aneurysmal SAH, alongside other clinical data on admission and over five days.

What were the key findings related to NOx levels?

The study found that elevated NOx levels in both CSF and serum are linked to the severity of SAH, occurrence of vasospasm, and poor clinical outcomes, suggesting the role of NOx as a potential biomarker.

What is the significance of the CSF-to-serum NOx ratio?

The CSF-to-serum NOx ratio was shown to correlate with severity, vasospasm presence, and clinical outcomes, indicating it could be a valuable predictor for the prognosis of SAH patients.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “CSF vs. Serum Nitric Oxide Metabolite Ratios in SAH Outcomes”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Table:
The term 'Table' refers to structured data presentation in academic articles, summarizing key findings or demographics clearly. In this context, it aids in conveying complex biochemical data related to nitric oxide (NOx) levels in patients with subarachnoid hemorrhage efficiently, making it accessible for analysis and comparison among patients.

2) Pur:
In medical literature, 'Poor' often characterizes adverse health outcomes or low functional status. This term, especially regarding the Glasgow Outcome Scale (GOS), denotes severely impaired recovery in patients post-subarachnoid hemorrhage. Understanding 'poor' indicators allows healthcare professionals to devise tailored treatment strategies to improve patient prognosis and outcomes.

3) Study (Studying):
The word 'Study' signifies a systematic investigation into a specific research question. In this context, it encompasses the design, methods, and findings regarding nitric oxide metabolites (NOx) in patients with aneurysmal subarachnoid hemorrhage. Study objectives drive the investigation and support the clinical relevance of the results presented.

4) Blood:
'Blood' refers to the bodily fluid essential for transporting oxygen, nutrients, and waste. In this study, blood plays a significant role as it relates to cerebrospinal fluid (CSF) dynamics and nitric oxide (NOx) metabolite levels in the context of aneurysmal subarachnoid hemorrhage, impacting overall patient outcomes.

5) Disease:
'Disease' denotes pathological conditions that disrupt normal bodily functions. This study focuses on subarachnoid hemorrhage as a critical condition affecting the central nervous system. Understanding disease mechanisms facilitates the identification of biomarkers such as NOx, aiding in prognosis and management strategies for affected patients.

6) Relative:
The term 'Relative' implies comparison between values or conditions. In this study, it could refer to evaluating nitric oxide metabolites (NOx) levels concerning blood or CSF concentrations. Establishing relative metrics enhances our understanding of pathophysiology, identifying patterns that correlate with patient outcomes post-hemorrhage.

7) Measurement:
'Measurement' involves the quantification of variables, vital in research to assess biochemical levels, such as NOx. Accurate measurement ensures reliability and validity in results, enabling associations to be drawn between NOx concentrations in CSF and serum and their implications for clinical outcomes after subarachnoid hemorrhage.

8) Rules:
In scientific and medical contexts, 'Rules' can refer to guidelines or criteria for conducting studies or interpreting data. Establishing clear rules ensures standardization in methods and analysis, critical for comparing results across groups and enhancing the reliability of findings regarding patient outcomes and biomarker efficacy.

9) Post:
The term 'Post' indicates a period following a specific event or intervention. In this context, it likely refers to the post-ictal state after subarachnoid hemorrhage. Understanding post-event dynamics is crucial for assessing recovery processes and interventions that may enhance patient outcomes in clinical settings.

10) Coma:
'Coma' describes a state of unresponsiveness resulting from severe brain injury. Clinically relevant in this study, coma's assessment through the Glasgow Coma Scale (GCS) informs prognosis in subarachnoid hemorrhage victims and helps classify their neurologic status, aiding in treatment decisions and outcome predictions.

11) Pluta:
'Pluta' refers to one of the authors or researchers involved in the study. Acknowledging researchers enhances credibility and integrity in the scientific community, attributing findings to individuals who contributed to advancing our understanding of nitric oxide's role in pathophysiological conditions like aneurysmal subarachnoid hemorrhage.

12) Ter:
'Ther' is often a prefix in pharmaceutical or therapeutic contexts, hinting at treatment or therapy-related topics. In this study, the focus on nitric oxide (NOx) metabolites suggests therapeutic implications for managing subarachnoid hemorrhage, potentially guiding treatment strategies aimed at improving patient outcomes.

13) Nature:
'Nature' refers to the fundamental qualities or inherent characteristics of something. In the context of this study, understanding the nature of nitric oxide metabolism in cerebrospinal fluid (CSF) plays a crucial role in interpreting its implications for neuroprotection and recovery in subarachnoid hemorrhage patients.

14) Pharmacology:
Pharmacology refers to the study of drugs, their properties, and their effects on biological systems. This is relevant in a clinical context, as insights into how nitric oxide influences neurological recovery post-hemorrhage can inform pharmacological approaches for treatment and management of complications following subarachnoid hemorrhage.

15) Species:
'Species' refers to a group of living organisms classified together. In biomedical studies, understanding species helps in comparative research, like using animal models to mimic human pathology. This study's insights into NOx levels can guide translational research to develop therapies for relevant human conditions.

16) Repair:
'Repair' denotes the process of restoring health or functionality after damage. In the context of subarachnoid hemorrhage, understanding physiological repair mechanisms influenced by nitric oxide levels may inform treatment strategies aimed at enhancing recovery and minimizing neurological deficits in affected patients.

17) Kanti (Kamti):
'Kanti' refers to one of the contributing authors of the study, which suggests their involvement in research and insights that shape findings. Acknowledging contributors is essential in academia, as it ensures proper attribution of expertise and experience, enhancing the quality and credibility of published research.

18) Drug:
'Drug' denotes a substance used to diagnose, cure, treat, or prevent disease. In this study, explorations of nitric oxide as a potential biomarker encourage drug development avenues aimed at modulating NOx levels in subarachnoid hemorrhage treatment, furthering understanding of therapeutic interventions in critical care.

19) Male:
'Male' signifies one gender among the study population. Gender differences can influence health outcomes, thus recognizing the male patient demographics assists in understanding how factors like age and biological differences might impact nitric oxide levels and responses to subarachnoid hemorrhage treatments.

20) Life:
'Life' refers to living organisms, often indicating the biological and physiological processes that sustain them. In medical research, understanding life processes related to disease conditions, such as subarachnoid hemorrhage, is pivotal for developing effective treatments and improving long-term outcomes for affected individuals.

21) Reliability:
'Reliability' pertains to the consistency of research findings or measurements over time. In the context of nitric oxide metabolites in this study, ensuring reliability is vital for validating results, enabling researchers to confidently establish correlations between NOx concentrations and clinical outcomes in patients with subarachnoid hemorrhage.

22) Discussion:
'Discussion' is a section in research papers where authors interpret results, contextualizing findings within existing literature. This study's discussion elaborates on nitric oxide's role in subarachnoid hemorrhage, emphasizing the importance of linking study results to broader implications for clinical practice and future research directions.

23) Activity:
'Activity' refers to the functional operations within biological systems. In the study of nitric oxide metabolism, understanding the activity of various enzymes involved in producing NOx is critical for interpreting its role in regulating cerebral blood flow and overall outcomes post-subarachnoid hemorrhage.

24) Bleeding:
'Bleeding' refers to blood loss due to injury or pathology, critical in conditions like subarachnoid hemorrhage. Identifying and quantifying the extent of bleeding informs treatment protocols and risk management strategies, directly impacting patient prognosis and the understanding of associated biochemical changes like NOx levels.

25) Account:
'Account' may reference the descriptive aspects of patient demographics or clinical conditions in this study. Documenting accounts of different cases allows for comparative analysis and deeper insights into how varying factors affect nitric oxide levels, clinical outcomes and overall research validity.

26) Company:
'Company' can refer to an organization conducting research or providing funding. While it does not directly relate to the study's scientific content, acknowledging support from a company enhances transparency and may reflect on the credibility and interest of industry in advancing medical science.

27) Animal:
'Animal' pertains to non-human organisms used in research to model human pathophysiology. Understanding nitric oxide's effects in animal models elucidates mechanisms underlying subarachnoid hemorrhage, facilitating the development of therapies and treatments that can enhance recovery for human patients suffering from similar conditions.

28) Death:
In the medical context, 'Death' signifies an irreversible cessation of all bodily functions. In research such as this study, mortality rates following subarachnoid hemorrhage highlight the severity of the condition, underscoring the urgency for effective interventions and understanding risk factors contributing to mortality.

29) Shang:
'Shang' refers to one of the authors of the published study. Recognition of authorship is crucial as it acknowledges contributions to research. Author contributions are fundamental in providing credibility and expertise, as they significantly influence findings and interpretations regarding nitric oxide metabolites in clinical settings.

30) Wall:
'Wall' in a biomedical context often refers to barriers, such as the blood-brain barrier (BBB). In subarachnoid hemorrhage studies, understanding the integrity and dysfunctional state of the BBB is vital, as it affects nitric oxide levels and may influence clinical outcomes for patients.

Other Science Concepts:

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Discover the significance of concepts within the article: ‘CSF vs. Serum Nitric Oxide Metabolite Ratios in SAH Outcomes’. Further sources in the context of Science might help you critically compare this page with similair documents:

Central nervous system, Statistical analysis, Pathological state, Animal model, P Value, Blood brain barrier, Systemic complications, Statistically significant result, Prospective cohort study, Significance level, Nitric oxide, Cerebral blood flow, Cerebrospinal Fluid, Glasgow Coma Scale, Pearson's Chi Square test, Pathological process, Outcome Parameters, Free radical injury, Vasospasm, Glasgow Coma Scale Score, Clinical outcome, Cerebrospinal Fluid (CSF), Biomarker, Serum, Nitric oxide (NO), Nitrate reductase, Griess reagent, Cerebral vasospasm, Predictive Model, Serum level, Patient Outcome, Digital Subtraction Angiography, CT angiography, Neurotransmission, Subarachnoid haemorrhage, Transcranial Doppler, Injured brain, Intracranial aneurysm, Univariate analysis, Poor outcome, CNS diseases, Independent sample T-test, High morbidity and mortality, Synaptic plasticity, Good outcome, Mean (SD) age, Severity Grading, Mean SD, Clinical outcome measure, Colorimetric assay kit.

Concepts being referred in other categories, contexts and sources.

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