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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Elevated soluble fas blood concentrations in patients dying from spontaneous intracerebral hemorrhage
Leonardo Lorente, María M Martín, Antonia Pérez-Cejas, Luis Ramos-Gómez, Jordi Solé-Violan, Juan J Cáceres, Alejandro Jiménez, Agustín F González-Rivero
Leonardo Lorente, Department of Intensive Care, Hospital Universitario de Canarias, La Laguna 38320, Tenerife, Spain
María M Martín, Department of Intensive Care, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife 38010, Tenerife, Spain
Antonia Pérez-Cejas, Agustín F González-Rivero, Department of Laboratory, Hospital Universitario de Canarias, La Laguna 38320, Tenerife, Spain
Luis Ramos-Gómez, Department of Intensive Care, Hospital Universitario de La Palma, Breña Alta 38713, Spain
Jordi Solé-Violan, Department of Critical Care, Hospital Universitario de Gran Canaria Dr Negrin, Las Palmas de Gran Canaria 35010, Spain
Jordi Solé-Violan, Department of Critical Care, Universidad Fernando Pessoa Canarias, Las Palmas de Gran Canaria 35450, Spain
Juan J Cáceres, Department of Intensive Care, Hospital Insular, Las Palmas de Gran Canaria 35016, Spain
Alejandro Jiménez, Research Unit, Hospital Universitario de Canarias, La Laguna 38320, Tenerife, Spain
Author contributions: Lorente L conceived, designed and coordinated the study, made substantial contributions to the acquisition, analysis and interpretation of data, and drafted the manuscript; Martín MM, Ramos-Gómez L, Solé-Violan J, and Cáceres JJ made substantial contributions to the acquisition of data and provided useful suggestions; Pérez-Cejas A and González-Rivero AF determined the blood concentrations; Jiménez A made substantial contributions to the data analysis and interpretation.
Institutional review board statement: The Institutional Board of each hospital approved the study protocol: H. General de La Palma, H. Insular de Las Palmas de Gran Canaria, H. Universitario de Canarias (San Cristóbal de La Laguna), H. Universitario Nuestra Señora de Candelaria (Santa Cruz de Tenerife), and H. Universitario Dr. Negrín (Las Palmas de Gran Canaria).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors have no conflicts of interest to declare.
Data sharing statement: The datasets generated during the current study are available from the corresponding author on reasonable request.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Leonardo Lorente, MD, PhD, Attending Doctor, Medical Assistant, Department of Intensive Care, Hospital Universitario de Canarias, Ofra s/n, La Laguna 38320, Tenerife, Spain. lorentemartin@msn.com
Received: October 14, 2022
Peer-review started: October 14, 2022
First decision: November 22, 2022
Revised: December 9, 2022
Accepted: February 1, 2023
Article in press: February 1, 2023
Published online: March 9, 2023
ARTICLE HIGHLIGHTS
Research background
Several studies of spontaneous intracerebral hemorrhage (SICH) patients have shown apoptotic changes in brain samples after hematoma evacuation.
Research motivation
There are no data on the association of blood concentrations of soluble fas (sFas) (the main surface death receptor of extrinsic apoptosis pathway) with SICH patient prognosis.
Research objectives
To determine whether there is an association between blood sFas concentrations and SICH patient mortality.
Research methods
We included patients with severe and supratentorial SICH. Severe was defined as having Glasgow coma scale < 9. We determined serum sFas concentrations at the time of severe SICH diagnosis.
Research results
We found that non-surviving patients (n = 36) compared to surviving patients (n = 39) had higher ICH score (P = 0.001), higher midline shift (P = 0.004), higher serum sFas concentrations (P < 0.001), and lower rate of early hematoma evacuation (P = 0.04). Multiple logistic regression analysis showed an association between serum sFas concentrations and 30-d mortality (odds ratio = 1.070; 95% confidence interval = 1.014-1.129; P = 0.01) controlling for ICH score, midline shift, and early hematoma evacuation.
Research conclusions
The association of blood sFas concentrations and SICH patient mortality is a novel finding in our study.
Research perspectives
The beneficial results of blockade of the Fas system in animal models could motivate its investigation in these patients.
