Abstract
Cerebral vasospasm (CVS) is the main complication of spontaneous subarachnoid hemorrhage (SAH), severely affecting clinical outcome of patients with SAH. Apolipoprotein E gene (APOE) is associated with prognosis of spontaneous subarachnoid hemorrhage (SAH), and APOEε4 allele is reported to be apt to CVS after SAH. The current study aimed to investigate the association of APOE polymorphisms with CVS after SAH. One hundred and eighty-five patients with spontaneous SAH were recruited in the study. APOE genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). CVS was judged by Transcranial Doppler sonography (TCD) combined with patients’ condition. χ2-test and logistic regression analysis were done by SPSS (version 11.5). The distributions of APOE genotypes and alleles matched Hardy–Weinberg Law. In 185 patients, 21 of 32 (65.7%) patients with APOEε4 allele showed CVS, which was significantly different from those without APOE ε4 allele (56 of 153 patients, 36.6%, P = 0.022). However, neither the presence of ε2 nor ε3 was significantly different from those absent of it (P > 0.05). Logistic regression analysis demonstrated that ApoEε4 allele was a risk factor (OR = 2.842.95%CI1.072–6.124.P = 0.019) to predispose to CVS after adjusting for age, sex, hypertension or not, hyperlipemia or not, Fisher grade, and Hunt–Hess grade after SAH. Our finding suggests that the patients with APOEε4 allele predispose to CVS after spontaneous SAH.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Alexander SA, Kerr ME, Balzer J, Horowitz M, Kassam A, Kim Y, et al. Cerebrospinal fluid apolipoprotein E, calcium and cerebral vasospasm after subarachnoid hemorrhage. Biol Res Nurs. 2008;10:102–12.
Fan J, Donkin J, Wellington C Greasing the wheels of Abeta clearance in Alzheimer’s disease: the role of lipids and apolipoprotein E. Biofactors 2009;35:239–48.
Gallek MJ, Conley YP, Sherwood PR, Horowitz MB, Kassam A, Alexander SA. APOE genotype and functional outcome following aneurysmal subarachnoid hemorrhage. Biol Res Nurs. 2009;10:205–212.
Hakan T, Berkman MZ, Ersoy T, Karatas I, San T, Arabk S Anti-inflammatory effect of meloxicam on experimental vasospasm in the rat femoral artery. J Clin Neurosci. 2008;15:55–59.
Hansen-Schwartz J, Hoel NL, Zbou M, Xu CB, Svendgaard NA, Edvinsson L. Subarachnoid hemorrhage enhances endothelin receptor expression and function in rat cerebral arteries. Neurosurgery 2003;52:1188–95.
Ionita CC, Graffagnino C, Alexander MJ, Zaidat OO. The value of CT angiography and traunscranial doppler sonography in triaging suspected cerebral vasospasm in SAH prior to endovascular therapy. Neurocrit Care. 2008;9:8–12.
Jiang Y, Sun X, Xia Y, Tang W, Cao Y, et al. Effect of APOE polymorphisms on early responses to traumatic brain injury. Neurosci Lett. 2006;408:155–8.
Juvela S, Siironen J, Lappalainen J. Apolipoprotein E genotype and outcome after aneurysmal subarachnoid hemorrhage. J Neurosurg. 2009;110:989–95.
Kay A, Petzold A, Kerr M, Keir G, Thompson E, Nicoll J. Temporal alterations in cerebrospinal fluid amyloid beta-protein and apolipoprotein E after subarachnoid hemorrhage. Stroke 2003;34:240–43.
Lahiri DK. Apolipoprotein E as a target for developing new therapeutics for Alzheimer`s disease based on studies from protein, RNA, and regulatory region of the gene. Mol Neurosci. 2004;23:225–33.
Lanterna LA, Rigoldi M, Tredici G, Biroli F, Cesana C, Gaini SM, et al. APOE influences vasospasm and cognition of noncomatose patients with subarachnoid hemorrhage. Neurology 2005;64:1238–44.
Louko AM, Vilkki J, Niskakangas T ApoE genotype and cognition after subarachnoid hemorrhage: a longitudinal study. Acta Neurol Scand. 2006;114:315–19.
Lynch JR, Tang W, Wang H, Vitek MP, Bennett ER, Sullivan PM, et al. APOE genotype and an ApoE-mimetic peptide modify the systemic and central nervous system inflammatory response. J Biol Chem. 2003;278:48529–33.
Martínez-González NA, Sudlow CL. Effects of apolipoprotein E genotype on outcome after ischaemic stroke, intracerebral haemorrhage and subarachnoid haemorrhage. J Neurol Neurosrug Psychiatry. 2006;77:1329–35.
Paris D, Town T, Parker TA, Humphrey J, Mullan M. Isoform-specific vasoconstriction induced by apolipoprotein E and modulation of this effect Alzheimer’s beta-amyloid peptide. Neurosci Lett. 1998;256:73–6.
Prunell GF. Svendgaard NA, Alkass K, Mathiesen T. Inflammation in the brain after experimental subarachnoid hemorrhage. Neurosurgery 2005;56:l082–92.
Wenham PR, Price WH, Blundell G. Apolipoprotein E genotyping by one-stage PCR. Lancet 1991;337:1158–59.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2011 Springer-Verlag/Wien
About this paper
Cite this paper
Wu, Ht., Zhang, Xd., Su, H., Jiang, Y., Zhou, S., Sun, Xc. (2011). Association of Apolipoprotein E Polymorphisms with Cerebral Vasospasm After Spontaneous Subarachnoid Hemorrhage. In: Feng, H., Mao, Y., Zhang, J.H. (eds) Early Brain Injury or Cerebral Vasospasm. Acta Neurochirurgica Supplements, vol 110/1. Springer, Vienna. https://doi.org/10.1007/978-3-7091-0353-1_24
Download citation
DOI: https://doi.org/10.1007/978-3-7091-0353-1_24
Publisher Name: Springer, Vienna
Print ISBN: 978-3-7091-0352-4
Online ISBN: 978-3-7091-0353-1
eBook Packages: MedicineMedicine (R0)