Sulfonylurea receptor-1 in cerebrospinal fluid as a biomarker for prognosis in patients with aneurysmal subarachnoid hemorrhage.

BACKGROUND: Sulfonylurea receptor-1 (Sur1) plays a crucial role in spontaneous intracerebral hemorrhage. This study aimed to determine whether cerebrospinal fluid (CSF) Sur1 concentration is associated with the prognosis in patients with aneurysmal subarachnoid hemorrhage (aSAH).

METHODS: A total of 585 CSF samples were collected from 117 patients with aSAH at 12 h, 24 h, 48 h, 72 h, and 96 h after the onset of hemorrhage, and CSF Sur1 concentrations were measured. Fifty-eight patients with normal pressure hydrocephalus were enrolled as the control group. Enzyme-linked immunosorbent assay (ELISA) was used to detect CSF Sur1 concentrations. Cranial computed tomography (CT) findings for cerebral edema, Glasgow Coma Scale (GCS) scores, and intracranial pressure (ICP) were recorded to assess the severity of the disease. A Glasgow Outcome Scale (GOS) score of 1-3 at 3 months after ictus was defined as a poor prognosis.

RESULTS: Sur1 was detectable in the CSF of all aSAH patients (mean = 3.47±2.53ng/mL, peak = 5.32±2.75ng/mL) but was undetectable in all controls (P < 0.001). Patients with CT-confirmed cerebral edema had significantly higher mean and peak Sur1 concentrations. A temporal delay between peak Sur1 and peak ICP was observed in 90.6% (106/117) of patients. Peak CSF Sur1 concentrations were significantly higher in patients with poor prognosis than in those with favorable outcomes.

CONCLUSIONS: Elevated CSF Sur1 concentration is highly associated with a poor prognosis in patients with aSAH, suggesting that CSF Sur1 may serve as a useful prognostic biomarker for aSAH.