Urokinase Plasminogen Activator Receptor: An Important Focal Player in Chronic Subdural Hematoma?

H-score. chronic subdural hematoma histology luminex pathophysiology recurrence recurrent CSDH urokinase plasminogen activator surface receptor

Journal

Inflammation
ISSN: 1573-2576
Titre abrégé: Inflammation
Pays: United States
ID NLM: 7600105

Informations de publication

Date de publication:
18 Jan 2024
Historique:
received: 01 12 2023
accepted: 23 12 2023
revised: 18 12 2023
medline: 18 1 2024
pubmed: 18 1 2024
entrez: 18 1 2024
Statut: aheadofprint

Résumé

Chronic subdural hematoma (CSDH) development involves inflammatory, angiogenetic, and fibrinolytic mechanisms, several components of which are now unraveled through intensive research. The urokinase plasminogen activator receptor (uPAR) is part of the plasminogen activator system and possesses inflammatory, angiogenetic, and fibrinolytic capabilities. As a first, this study aims to identify uPAR in the hematoma fluid, hematoma membrane, dura mater, and systemic blood from patients with CSDH and, if present, to investigate if the uPAR level at the time of surgery may be a predictor for later developing recurrent CSDH. uPAR expression in the hematoma membrane and dura mater was analyzed using immunohistochemistry and presented as the H-score of the positive immunostaining. The uPAR levels in the hematoma fluid and systemic blood were determined using a multiplex antibody bead kit (Luminex). Samples were collected at the time of the first CSDH surgery, and in the case of recurrent CSDH within 90 days, the samples were again collected at reoperation. A comparison of uPAR expression between the hematoma membrane and dura mater, as well as uPAR levels in systemic blood and hematoma fluid, was performed using the Wilcoxon rank sum test. We included 112 patients, 26 of whom had recurrent CSDH. The median hematoma uPAR level was 22,125 (14,845-33,237) and significantly higher than the median systemic blood level of 789 pg/L (465-2,088) (p < 0.001). Similarly, the uPAR level of the hematoma membrane was 14.3 (7.54-44.8) and significantly higher than the dural uPAR level of 0.81 (0.3-1.98) (p < 0.001). For the first time, we identified uPAR in the subdural fluid, hematoma membrane, dura mater, and systemic blood from patients with CSDH. The high expression of uPAR in the subdural fluid and hematoma membrane indicates that the mechanisms of CSDH are predominantly in the subdural fluid collection and surrounding hematoma membrane.

Identifiants

pubmed: 38236383
doi: 10.1007/s10753-023-01957-5
pii: 10.1007/s10753-023-01957-5
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : ERC Advanced Grant
ID : 670261
Organisme : the Danish National Research Foundation
ID : 126

Informations de copyright

© 2024. The Author(s).

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Auteurs

Thorbjørn Søren Rønn Jensen (TSR)

Department of Neurosurgery, The Neuroscience Center, Copenhagen University Hospital, Inge Lehmanns Vej 6, 2100, Rigshospitalet, Copenhagen, Denmark. tjens07@gmail.com.

Markus Harboe Olsen (MH)

Department of Neuroanesthesiology, The Neuroscience Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Department of Anaesthesiology, Zealand University Hospital, Køge, Denmark.

Giedrius Lelkaitis (G)

Department of Pathology, Rigshospitalet, Copenhagen, Denmark.

Andreas Kjaer (A)

Department of Clinical Physiology, Nuclear Medicine and PET & Cluster for Molecular Imaging, Copenhagen University Hospital-Rigshospitalet & Department of Biomedical Sciences, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark.

Tina Binderup (T)

Department of Clinical Physiology, Nuclear Medicine and PET & Cluster for Molecular Imaging, Copenhagen University Hospital-Rigshospitalet & Department of Biomedical Sciences, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark.

Kåre Fugleholm (K)

Department of Neurosurgery, The Neuroscience Center, Copenhagen University Hospital, Inge Lehmanns Vej 6, 2100, Rigshospitalet, Copenhagen, Denmark.

Classifications MeSH