Increased level of LIGHT/TNFSF14 is associated with survival in aneurysmal subarachnoid hemorrhage.

Abstract

Multiple cytokines have been implicated in aneurysmal subarachnoid hemorrhage (aSAH), but tumor necrosis factor superfamily 14 (LIGHT/TNFSF14) and oncostatin-M (OSM) have not been previously explored. The primary objective of this study was to examine the relationship between TNFSF14 and OSM levels and survival. Our secondary goal was to investigate a potential association between these markers and the incidence of delayed cerebral ischemia (DCI). We consecutively recruited 60 patients with a clinical diagnosis of aSAH. LIGHT/TNFSF14 and OSM serum concentrations were determined by ELISA. The primary endpoint was survival at Day 30, while development of DCI was assessed as secondary outcome. Patients had significantly higher levels of both markers than the control group (median of LIGHT: 18.1pg/ml vs. 7pg/ml; p=0.01; median of OSM: 10.3pg/ml vs. 2.8pg/ml, p<0.001). Significantly lower serum level of LIGHT/TNFSF14 was found in nonsurviving patients (n=9) compared with survivors (n=51; p=0.011). Based on ROC analysis, serum LIGHT/TNFSF14 with a cutoff value of >7.95pg/ml predicted 30-day survival with a sensitivity of 71% and specificity of 78% (Area: 0.763; 95% CI: 0.604-0.921, p=0.013). In addition, it was also a predictor of DCI with a sensitivity of 72.7% and a specificity of 62.5% (AUC: 0.702; 95% CI: 0.555-0.849, p=0.018). Based on binary logistic regression analysis, LIGHT/TNFSF14 was found to be independently associated with 30-day mortality, but not with DCI. In this cohort, a higher serum level of LIGHT/TNFSF14 was associated with increased survival of patients with aSAH.