Haptoglobin and the development of cerebral artery vasospasm after subarachnoid hemorrhage

M. Borsody*, A. Burke, W. Coplin, R. Miller-Lotan, A. Levy

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

70 Scopus citations

Abstract

Background: Vasospasm is a prolonged constriction of a cerebral artery that is induced by hemoglobin after subarachnoid hemorrhage (SAH). The subarachnoid blood clot also contains the protein haptoglobin, which acts to neutralize hemoglobin. Because the haptoglobin α gene is dimorphic, a person can expresses only one of three types of haptoglobin (α1-α1, α1-α2, or α2-α2) depending on the α subunit genes he or she inherits. Each of these three haptoglobin types has different antihemoglobin activities; therefore, haptoglobin may influence the development of vasospasm differently in various patients with SAH. Objective: To determine whether SAH patients who have haptoglobin containing the α2 subunit would be more likely to develop vasospasm than would be SAH patients who have haptoglobin α1-α1. Methods and Results: A total of 32 patients with Fisher Grade 3 SAH were enrolled in this study. Haptoglobin type was determined by polyacrylamide gel electrophoresis. The primary measure for vasospasm was increased blood flow velocities as detected by daily transcranial Doppler ultrasonography (TCD). The authors found that only 2 of 9 patients with haptoglobin α1-α1 (22%) had development of "possible" vasospasm as measured by TCD, whereas 20 of 23 patients with the haptoglobin α2 subunit (either the α1-α2 or α2-α2 haptoglobin types) had development of "possible" vasospasm (87%). The secondary measure for vasospasm was cerebral angiography performed between 3 and 14 days after SAH. Similar results (17% vs 56%) were seen between these groups in those patients who underwent cerebral angiography, although its inconsistent use limited the strength of the statistical comparison. Conclusions: Haptoglobins containing the α2 subunit seem to be associated with a higher rate of vasospasm than is haptoglobin α1-α1.

Original languageEnglish (US)
Pages (from-to)634-640
Number of pages7
JournalNeurology
Volume66
Issue number5
DOIs
StatePublished - Mar 1 2006

ASJC Scopus subject areas

  • Clinical Neurology

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