Serum microtubule associated protein tau and myelin basic protein as the potential markers of brain ischaemia-reperfusion injury in patients undergoing carotid endarterectomy
Abstract
Introduction. In the prevention of ischaemic stroke the recommended surgical procedure is carotid endarterectomy (CEA). However, surgical treatment of atherosclerotic stenosis may cause neurological complications. The aim of the study was to investigate consequential brain ischaemia-reperfusion injury by measuring the cerebral specific markers, the microtubule associated protein tau (MAPt) and myelin basic protein (MBP) in the serum of patients that underwent CEA.
Material and methods. This study involved 25 participants who underwent CEA due to internal carotid artery stenosis. Blood samples were taken from each patient at three different intervals; within 24 hours prior to surgery, 12 hours after the surgery, and 48 hours after the surgery. Serum MAPt and MBP levels were measured by a commercially available enzyme-linked immunosorbent assay (ELISA).
Results. The study showed that serum MAPt and MBP levels were statistically significantly decreased 12 hours after CEA compared to the level before the surgery (p < 0.05), but MAPt and MBP levels were normalized 48 hours after CEA. There was statistically significant correlation in serum MAPt levels with the velocity of blood flow in the internal carotid artery 12 and 48 hours after CEA (p < 0.05).
Conclusions. Data from our study showed that CEA affects serum neuromarkers levels, such as MAPt and MBP, in patients with significant internal carotid artery stenosis. MAPt and MBP levels showed characteristic time curve in patients who underwent CEA and did not experience any neurological deficit in perioperative period. Possible alterations of this time curve may potentially be an index of a neurological event occurrence.
Keywords: carotid endarterectomymicrotubule associated protein taumyelin basic proteinneuromarkersserum
References
- Yacoub HA, Al-Qudah ZA, Khan HMR, et al. Trends in Outcome and Hospitalization Cost among Adult Patients with Acute Ischemic Stroke in the United States. J Vasc Interv Neurol. 2015; 8(2): 19–23.
- Wu Lf, Lai Zc, Liu Cw, et al. [Advances in the biochemical markers of complications associated with carotid endarterectomy]. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2013; 35(3): 357–361.
- Gupta N, Corriere MA, Dodson TF, et al. The incidence of microemboli to the brain is less with endarterectomy than with percutaneous revascularization with distal filters or flow reversal. J Vasc Surg. 2011; 53(2): 316–322.
- Backhaus R, Boy S, Fuchs K, et al. Hyperperfusion syndrome after MCA embolectomy - a rare complication? Am J Case Rep. 2013; 14: 513–517.
- Ballesteros-Pomar M, Alonso-Argüeso G, Tejada-García J, et al. [Cerebral hyperperfusion syndrome in carotid revascularisation surgery]. Rev Neurol. 2012; 55(8): 490–498.
- Holm J, Nilsson U, Waters N, et al. Production of free radicals measured by spin trapping during operations for stenosis of the carotid artery. Eur J Surg. 2001; 167: 4–9.
- Bowen DM, Smith CB, White P, et al. Neurotransmitter-related enzymes and indices of hypoxia in senile dementia and other abiotrophies. Brain. 1976; 99(3): 459–496.
- Johnson GV, Jenkins SM. Tau protein in normal and Alzheimer's disease brain. J Alzheimers Dis. 1999; 1(4-5): 307–328.
- Hu HT, Xiao F, Yan YQ, et al. The prognostic value of serum tau in patients with intracerebral hemorrhage. Clin Biochem. 2012; 45(16-17): 1320–1324.
- Liliang PC, Liang CL, Weng HC, et al. Tau proteins in serum predict outcome after severe traumatic brain injury. J Surg Res. 2010; 160(2): 302–307.
- Noguchi-Shinohara M, Hamaguchi T, Nozaki I, et al. Serum tau protein as a marker for the diagnosis of Creutzfeldt-Jakob disease. J Neurol. 2011; 258(8): 1464–1468.
- Süssmuth SD, Uttner I, Landwehrmeyer B, et al. Differential pattern of brain-specific CSF proteins tau and amyloid-β in Parkinsonian syndromes. Mov Disord. 2010; 25(9): 1284–1288.
- Süssmuth SD, Sperfeld AD, Hinz A, et al. CSF glial markers correlate with survival in amyotrophic lateral sclerosis. Neurology. 2010; 74(12): 982–987.
- Boggs JM. Myelin basic protein: a multifunctional protein. Cell Mol Life Sci. 2006; 63(17): 1945–1961.
- Zhao Li, Guo Y, Ji X, et al. The neuroprotective effect of picroside II via regulating the expression of myelin basic protein after cerebral ischemia injury in rats. BMC Neurosci. 2014; 15: 25.
- Chida Y, Kokubo Y, Sato S, et al. The alterations of oligodendrocyte, myelin in corpus callosum, and cognitive dysfunction following chronic cerebral ischemia in rats. Brain Res. 2011; 1414: 22–31.
- Rostami E, Davidsson J, Ng KC, et al. A Model for Mild Traumatic Brain Injury that Induces Limited Transient Memory Impairment and Increased Levels of Axon Related Serum Biomarkers. Front Neurol. 2012; 3: 115.
- Gyorgy A, Ling G, Wingo D, et al. Time-dependent changes in serum biomarker levels after blast traumatic brain injury. J Neurotrauma. 2011; 28(6): 1121–1126.
- Tian Zj, Zhao Xx, Li Zh, et al. [Evaluation of myelin basic protein levels with receiver operating characteristic curves for diagnosis of multiple sclerosis]. Nan Fang Yi Ke Da Xue Xue Bao. 2009; 29(2): 250–252.
- Liapis CD, Bell PRF, Mikhailidis D, et al. ESVS Guidelines Collaborators. ESVS guidelines. Invasive treatment for carotid stenosis: indications, techniques. Eur J Vasc Endovasc Surg. 2009; 37(4 Suppl): 1–19.
- Staikov IN, Arnold M, Mattle HP, et al. Comparison of the ECST, CC, and NASCET grading methods and ultrasound for assessing carotid stenosis. European Carotid Surgery Trial. North American Symptomatic Carotid Endarterectomy Trial. J Neurol. 2000; 247(9): 681–686.
- Komoribayashi N, Ogasawara K, Kobayashi M, et al. Cerebral hyperperfusion after carotid endarterectomy is associated with preoperative hemodynamic impairment and intraoperative cerebral ischemia. J Cereb Blood Flow Metab. 2006; 26(7): 878–884.
- Song Bo, Ao Q, Wang Z, et al. Phosphorylation of tau protein over time in rats subjected to transient brain ischemia. Neural Regen Res. 2013; 8(34): 3173–3182.
- Zheng GQ, Wang XM, Wang Y, et al. Tau as a potential novel therapeutic target in ischemic stroke. J Cell Biochem. 2010; 109(1): 26–29.
- Wen Yi, Yang S, Liu R, et al. Transient cerebral ischemia induces site-specific hyperphosphorylation of tau protein. Brain Res. 2004; 1022(1-2): 30–38.
- Mailliot C, Podevin-Dimster V, Rosenthal RE, et al. Rapid tau protein dephosphorylation and differential rephosphorylation during cardiac arrest-induced cerebral ischemia and reperfusion. J Cereb Blood Flow Metab. 2000; 20(3): 543–549.
- Bitsch A, Horn C, Kemmling Y, et al. Serum tau protein level as a marker of axonal damage in acute ischemic stroke. Eur Neurol. 2002; 47(1): 45–51.
- Wunderlich MT, Lins H, Skalej M, et al. Neuron-specific enolase and tau protein as neurobiochemical markers of neuronal damage are related to early clinical course and long-term outcome in acute ischemic stroke. Clin Neurol Neurosurg. 2006; 108(6): 558–563.
- Chen Y, Yi Q, Liu G, et al. Cerebral white matter injury and damage to myelin sheath following whole-brain ischemia. Brain Res. 2013; 1495: 11–17.
- Chida Y, Kokubo Y, Sato S, et al. The alterations of oligodendrocyte, myelin in corpus callosum, and cognitive dysfunction following chronic cerebral ischemia in rats. Brain Res. 2011; 1414: 22–31.
- Cai QY, Chen XS, Zhan XL, et al. Protective effects of catalpol on oligodendrocyte death and myelin breakdown in a rat model of chronic cerebral hypoperfusion. Neurosci Lett. 2011; 497(1): 22–26.
- Li A, Lv S, Yu Z, et al. Simvastatin attenuates hypomyelination induced by hypoxia-ischemia in neonatal rats. Neurol Res. 2010; 32(9): 945–952.
- Fan LW, Lin S, Pang Yi, et al. Hypoxia-ischemia induced neurological dysfunction and brain injury in the neonatal rat. Behav Brain Res. 2005; 165(1): 80–90.
- Brouns R, De Vil B, Cras P, et al. Neurobiochemical markers of brain damage in cerebrospinal fluid of acute ischemic stroke patients. Clin Chem. 2010; 56(3): 451–458.
- Hjalmarsson C, Bjerke M, Andersson B, et al. Neuronal and glia-related biomarkers in cerebrospinal fluid of patients with acute ischemic stroke. J Cent Nerv Syst Dis. 2014; 6: 51–58.
- Rasmussen LS, Christiansen M, Johnsen J, et al. Subtle brain damage cannot be detected by measuring neuron-specific enolase and S-100beta protein after carotid endarterectomy. J Cardiothorac Vasc Anesth. 2000; 14(2): 166–170.
- Brightwell RE, Sherwood RA, Athanasiou T, et al. The neurological morbidity of carotid revascularisation: using markers of cellular brain injury to compare CEA and CAS. Eur J Vasc Endovasc Surg. 2007; 34(5): 552–560.
- Céspedes AE, Arango CA, Cardona GP. [Injury markers in two models of cerebral ischemia]. Biomedica. 2013; 33(2): 292–305.
- Seiberlich V, Bauer NG, Schwarz L, et al. Downregulation of the microtubule associated protein tau impairs process outgrowth and myelin basic protein mRNA transport in oligodendrocytes. Glia. 2015; 63(9): 1621–1635.