Comparison of Resolvin D1 Levels in Patients with Aneurysmal Subarachnoid Haemorrhage with Those in Healthy Controls

Abstract

Objective: The literature points to the role of neuroinflammation in the aetiology of vasospasm, which is the leading cause of mortality and morbidity after aneurysmal subarachnoid haemorrhage. Neuroinflammation has been found to contribute to early and delayed brain injury, both of which are associated with poor clinical outcomes. Resolvin D1 is hypothesised to have a protective effect on neurons against apoptosis and has anti-inflammatory and pro-resolving effects on the neuroinflammation and vasospasm after aneurysmal subarachnoid haemorrhage. In this study, we aimed to investigate the serum resolvin D1 levels and its possible relationship with vasospasm and inflammatory markers, such as C-reactive protein, neutrophil and albumin in patients with aneurysmal subarachnoid haemorrhage. Methods: Fifteen patients with spontaneous aneurysmal subarachnoid haemorrhage between June 2017 and May 2018 presenting at our institution were included in the study. Their data were compared with those of 17 healthy volunteers. Patients with aneurysmal subarachnoid haemorrhage were divided into two groups: the subarachnoid haemorrhage with vasospasm group (8 patients), which included patients with subarachnoid haemorrhage and angiographic vasospasm , and subarachnoid haemorrhage without vasospasm group (7 patients), which included patients with subarachnoid haemorrhage without angiographic vasospasm. Serial serum resolvin D1 measurements were taken on days 1, 4, 9 and 14 after subarachnoid haemorrhage. Results: Resolvin D1 levels were statistically significantly higher on day 1 after subarachnoid haemorrhage in patients with angiographic vasospasm (p=0.021). Additionally, in the group with angiographic vasospasm, all the measured resolvin D1 values were also higher compared to other groups. The measurements of serum C-reactive protein and neutrophil levels were found to be statistically significantly higher on day 1 after subarachnoid haemorrhage in both groups compared to the control group. Conclusion: Resolvin D1 levels tend to increase secondary to inflammation because of its neuroprotective and anti-inflammatory properties. Thus, high resolvin D1levels in the subarachnoid haemorrhage + vasospasm group indicated that inflammatory processes play a role in the aetiopathogenesis of angiographic vasospasm after aneurysmal subarachnoid haemorrhage. Consequently, resolvin D1 might be an important biomarker in the prediction of the angiographic vasospasm after aneurysmal subarachnoid haemorrhage.