Relationships between the expressions of HIF-1α and miR-210 in serum and cerebral vasospasm after intracranial aneurysm rupture hemorrhage

Abstract

Objective To detect the expressions of hypoxia inducible factor-1α (HIF-1α) and miRNA-210 (miR-210) in serum after intracranial aneurysm rupture hemorrhage, and to explore their relationships with cerebral vasospasm (CVS). Methods Eighty-seven patients with ruptured intracranial aneurysms who underwent emergency spontaneous subarachnoid hemorrhage (SAH) and interventional embolization or craniotomy from January 2015 to December 2018, were selected as the subjects of study. The occurrence of CVS was assessed by head X-ray, CT and whole brain digital subtraction angiography (DSA), the severity of CVS was assessed, the expression of HIF-1α in serum was detected by ELISA and the expression of miR-210 in serum was detected by qRT-PCR. To analyze the relationship between the expressions of HIF-1α and miR-210 in serum after intracranial aneurysm rupture and hemorrhage, and ROC curve was used to analyze the diagnostic values of serum HIF-1α and miR-210 levels in patients with CVS at 3rd day after intracranial aneurysm rupture and hemorrhage. Results Thirty-seven patients (42.53%) had postoperative CVS after operation in 87 patients with ruptured intracranial aneurysms,including 10 patients with mild CVS (11.49%), 19 patients with moderate CVS (21.84%) and 8 patients with moderate CVS (90.20%). The levels of HIF-1α and miR-210 in serum of CVS patients in varying degrees were significantly higher than those of non-CVS patients at 3rd day and 7th day after operation (P<0.05), and the higher the severity of CVS, the higher the expression levels of serum HIF-1α and miR-210. The levels of HIF-1α and miR-210 in serum of CVS patients at 3rd day and 7th day after operation were significantly higher than those before operation (P<0.05), and the levels of HIF-1α and miR-210 at 7th day after operation were significantly lower than those at 3rd day after operation (P<0.05). Serum HIF-1α level was positively correlated with miR-210 level in patients with ruptured intracranial aneurysms 3rd and 7th day after operation (r=0.381, r=0.631, P<0.05). On the 3rd day after operation, the areas under the curve of levels of serum HIF-1α, miR-210 and HIF-1α+miR-210 diagnosing CVS in patients with ruptured intracranial aneurysm hemorrhage were 0.834, 0.769 and 0.900, respectively, and the sensitivity and accuracy of combined diagnosis of CVS were 93.06% and 87.36%, which were higher than those of single index detections. Conclusion Levels of serum HIF-1α and miR-210 after intracranial aneurysm rupture and hemorrhage can effectively predict the occurrence of CVS, and they may be important biological indicators of the occurrence and development of CVS. Key words: Ruptured intracranial aneurysm hemorrhage; Cerebral vasospasm; Hypoxia inducible factor; miR-210