Serum concentrations of NLRP3 in relation to functional outcome and delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.

BACKGROUND

Nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3 (NLRP3) participates in neuroinflammation. We endeavored to determine the role of serum NLRP3 as a biomarker of neuroinflammation, severity, delayed cerebral ischemia (DCI) and functional outcome following aneurysmal subarachnoid hemorrhage (aSAH).

METHODS

In this prospective and observational study, a total of 118 aSAH patients and 118 healthy volunteers were enrolled. Serum NLRP3 concentrations, blood glucose concentrations, serum C-reactive protein concentrations, and blood leucocyte counts were quantified. A poor outcome was defined as extended Glasgow outcome scale scores of 1-4 at post-injury 90 days.

RESULTS

As compared to controls, significantly increased serum NLRP3 concentrations after aSAH were intimately correlated with the Glasgow coma scale scores, World Federation of Neurological Surgeons scale scores, Hunt-Hess scores, modified Fisher scores, extended Glasgow outcome scale scores, blood glucose concentrations, serum C-reactive protein concentrations and blood leucocyte counts. Serum NLRP3 emerged as an independent predictor for DCI and poor 90-day outcome. Using receiver operating characteristic curve, serum NLRP3 concentrations were significantly predictive of DCI and poor 90-day outcome. Its prognostic predictive ability was comparable to those of the Glasgow coma scale scores, World Federation of Neurological Surgeons scale scores, Hunt-Hess scores and modified Fisher scores.

CONCLUSIONS

Serum NLRP3 may represent an inflammatory biomarker in relation to the severity, DCI and poor functional outcome after aSAH.