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Abstract
Objectives: To assess the involvement of ficolin-3, the main initiator of the lectin complement pathway (LCP), in subarachnoid hemorrhage (SAH) pathology and outcome.
Methods: In this preliminary exploratory study, plasma concentration of ficolin-3 and of ficolin-3–mediated functional LCP activity was measured, along with that of other LCP initiators (mannose-binding lectin, ficolin-2, and ficolin-1), C3 activation products, and soluble C5b-9 terminal complex, in a prospective cohort of 39 patients with SAH and 20 healthy controls. The following parameters were recorded: SAH severity, assessed using the World Federation of Neurosurgical Societies grading scale; vasospasm, defined as neuro-worsening with angiographic confirmation of vessel narrowing; cerebral ischemia, defined as hypodense lesion on CT scan performed before discharge; and 6-month outcome, assessed using the Glasgow Outcome Scale.
Results: In patients, no changes were detected for ficolin-3 compared with controls. Notably, however, ficolin-3–mediated functional LCP activity was reduced. Low levels of plasma ficolin-3 and ficolin-3–mediated functional LCP activity were related to SAH severity, vasospasm, and cerebral ischemia. Moreover, ficolin-3 functional LCP activity was decreased in patients with unfavorable outcome.
Conclusion: Our data provide evidence that LCP is activated after SAH and that the actual plasma concentrations of ficolin-3 reflect the severity of brain injury as evaluated by clinical and structural parameters. These results support the idea that ficolin-3–mediated functional LCP activity may be targeted to control injury progression in SAH.
GLOSSARY
- CRP=
- C-reactive protein;
- DCI=
- delayed cerebral ischemia;
- EDTA=
- ethylenediaminetetraacetic acid;
- GOS=
- Glasgow Outcome Scale;
- LCP=
- lectin complement pathway;
- MASP=
- mannose-binding lectin-associated serine protease;
- MBL=
- mannose-binding lectin;
- NHSP=
- normal human serum pool;
- OD=
- optical density;
- PBS=
- phosphate-buffered saline;
- SAH=
- subarachnoid hemorrhage;
- sC5b-9=
- soluble C5b-9;
- WFNS=
- World Federation of Neurosurgical Societies
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
↵* These authors contributed equally to this work.
Supplemental data at www.neurology.org
- Received June 5, 2013.
- Accepted in final form September 27, 2013.
- © 2014 American Academy of Neurology
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