Circulating collagen breakdown products as a biomarker for presence and instability of human intracranial aneurysms.

IF 5.8 3区医学 Q1 CLINICAL NEUROLOGY European Stroke Journal Pub Date : 2024-11-16 DOI:10.1177/23969873241300057

Katharina Am Hackenberg, Peter Richter, Svetlana Hetjens, Rita Dreier, Thomas Ratliff, Oluwadamilola Akanji, Judith Dremel, Amr Abdulazim, Ibrahim Al Masalmeh, Mansour Alzghloul, Eva Neumaier-Probst, Christoph Groden, Sherry H-Y Chou, Gabriel Je Rinkel, Nima Etminan

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Abstract

Introduction: There is an unmet need for improved detection of intracranial aneurysms (IAs) and distinction between stable and unstable (high rupture risk) IAs. Within the IA wall, synthesis and degradation of type I collagen as the main molecular constituent balance each other to maintain IA stability. We hypothesized that collagen breakdown products could serve as molecular markers for IA presence and instability.

Patients and methods: This prospective, cross-sectional, single-center study included patients with unstable (growing/symptomatic/ruptured) and stable IAs and controls. We determined C-telopeptide (CTx) and c-terminal telopeptide (ICTP) as breakdown products of type I collagen in arterial and venous blood.

Results: We included 107 participants with IAs (52 stable/44 unstable) and 41 controls. The correlation between intra-aneurysmal and venous levels was r = 0.63 (p < 0.001) for ICTP, r = 0.55 (p = 0.001) for CTx. The odds of harboring an IA were five times higher for participants with high compared to low venous levels of collagen breakdown products (ICTP: odds ratio (OR) 4.9 (95% CI 1.1-22.7); CTx: OR 5.3 (95% CI 1.4-20.0)). The OR for having an unstable IA was 9.3 (95% CI 2.1-41.5) for patients with high compared to low venous ICTP levels. The area under the curve for ICTP levels as a marker for IA instability was 0.75.

Discussion and conclusion: Increased levels of venous collagen breakdown products, especially ICTP levels, could serve as a biomarker for IA presence and instability and complement current data for management of unruptured IAs on an individual patient level. Future studies with longitudinal data are needed to validate ICTP as a biomarker for high risk IAs.

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将循环胶原分解产物作为人类颅内动脉瘤存在和不稳定的生物标志物。

导言：对颅内动脉瘤（IAs）的检测和区分稳定和不稳定（高破裂风险）IAs的需求尚未得到满足。在动脉瘤壁内，作为主要分子成分的 I 型胶原蛋白的合成和降解相互平衡，以维持动脉瘤的稳定性。我们假设胶原蛋白的分解产物可作为IA存在和不稳定的分子标记：这项前瞻性、横断面、单中心研究纳入了不稳定型（生长型/无症状型/破裂型）和稳定型IA患者及对照组。我们测定了动脉血和静脉血中I型胶原蛋白的分解产物C-端肽（CTx）和c-端端肽（ICTP）：我们纳入了107名IAs患者（52名稳定型/44名不稳定型）和41名对照组。动脉瘤内和静脉血中 CTx 水平的相关性为 r = 0.63（p r = 0.55（p = 0.001））。静脉中胶原分解产物水平高的参与者罹患内脏癌的几率是静脉中水平低的参与者的五倍（ICTP：几率比 (OR) 4.9 (95% CI 1.1-22.7)；CTx：5.3（95% CI 1.4-20.0））。静脉 ICTP 水平高的患者与静脉 ICTP 水平低的患者相比，IA 不稳定的 OR 为 9.3（95% CI 2.1-41.5）。ICTP水平作为IA不稳定性标志的曲线下面积为0.75：静脉胶原分解产物水平的升高，尤其是ICTP水平的升高，可作为IA存在和不稳定的生物标志物，并可补充目前对未破裂IA进行个体化管理的数据。未来需要进行纵向数据研究，以验证ICTP作为高风险IA的生物标志物的有效性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Stroke Journal Multiple-

CiteScore

7.50

自引率

6.60%

发文量

102

期刊介绍： Launched in 2016 the European Stroke Journal (ESJ) is the official journal of the European Stroke Organisation (ESO), a professional non-profit organization with over 1,400 individual members, and affiliations to numerous related national and international societies. ESJ covers clinical stroke research from all fields, including clinical trials, epidemiology, primary and secondary prevention, diagnosis, acute and post-acute management, guidelines, translation of experimental findings into clinical practice, rehabilitation, organisation of stroke care, and societal impact. It is open to authors from all relevant medical and health professions. Article types include review articles, original research, protocols, guidelines, editorials and letters to the Editor. Through ESJ, authors and researchers have gained a new platform for the rapid and professional publication of peer reviewed scientific material of the highest standards; publication in ESJ is highly competitive. The journal and its editorial team has developed excellent cooperation with sister organisations such as the World Stroke Organisation and the International Journal of Stroke, and the American Heart Organization/American Stroke Association and the journal Stroke. ESJ is fully peer-reviewed and is a member of the Committee on Publication Ethics (COPE). Issues are published 4 times a year (March, June, September and December) and articles are published OnlineFirst prior to issue publication.