Chemokines in Chronic Subdural Hematoma [Neurosurgery Wiki]

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====== Chemokines in Chronic Subdural Hematoma ======

[[Chronic subdural hematoma]] (CSDH) is considered an inflammatory disease because [[angiogenesis]]. [[Chemokine]]s attract [[leukocyte]]s, and invading [[neutrophil]]s and monocytes/macrophages play important roles in wound healing. 

Chemokines are elevated in the hematoma cavity of patients with CSDH. It is likely that these signaling modulators play an important role in promoting local inflammation. Furthermore, biological activity of [[CCL2]] and [[CXCL8]] may promote neovascularization within the outer CSDH membrane, and a compensatory angiostatic activity of [[CXCL9]] and [[CXCL10]] may contribute to repairing this disorder. This phenomenon was restricted to the hematoma site, and the systemic chemokine levels might not reflect local immune responses
((Stanisic M, Lyngstadaas SP, Pripp AH, Aasen AO, Lindegaard KF, Ivanovic J, Ilstad E, Konglund A, Sandell T, Ellingsen O, Saehle T. Chemokines as markers of local inflammation and angiogenesis in patients with chronic subdural hematoma: a prospective study. Acta Neurochir (Wien). 2012 Jan;154(1):113-20; discussion 120. doi: 10.1007/s00701-011-1203-2. Epub 2011 Oct 26. PMID: 22037980.)).
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Osuka et al. randomly divided patients who underwent trepanation surgery into two groups. One was the [[irrigation]] group, in which irrigation of CSDH fluids was performed and a drainage tube was placed (n = 10). The other was the non-irrigation group, in which a drainage tube was inserted without irrigation (n = 10). CSDH fluids were collected during the trepanation surgery, immediately after surgery and on day 1 through the drainage tube. The concentrations of [[interleukin 8]] ([[IL-8]]), [[Growth Regulated Oncogene-α ]] (GRO-α), [[epithelial neutrophil-activating peptide 78]] (ENA-78), [[monocyte chemoattractant protein-1]] (MCP-1), [[interferon-γ-induced protein-10]] (IP-10), tissue plasminogen activator (tPA), von Willebrand factor (vWF), eotaxin-3, and myeloperoxidase (MPO) in each CSDH fluid sample were measured using enzyme-linked immunosorbent assay kits. After irrigation, concentrations of all chemokines decreased. However, concentrations of IL-8, GRO-α, ENA-78, MCP-1, and MPO were significantly increased on day 1 compared with concentrations during surgery with or without irrigation. In contrast, there were no changes in concentrations of IP-10, eotaxin-3, tPA, or vWF after trepanation surgery. Moreover, there were significant relationships among concentrations of IL-8, GRO-α, ENA-78, and MCP-1 during the surgery and on day 1. In CSDH fluids, chemokines that attract neutrophils, such as IL-8, GRO-α, ENA-78, and macrophage-attracting MCP-1, appear first after trepanation surgery, whereas lymphocyte-attracting IP-10 and eosinophil-attracting eotaxin-3 levels do not change within 1 day of surgery. These findings suggest that [[neutrophil]]s and [[macrophage]]s may play important roles in the healing process of CSDH at an early stage
((Osuka K, Ohmichi Y, Ohmichi M, Nakura T, Iwami K, Watanabe Y, Miyachi S. Sequential Expression of Chemokines in Chronic Subdural Hematoma Fluids after Trepanation Surgery. J Neurotrauma. 2021 Jan 27. doi: 10.1089/neu.2020.7401. Epub ahead of print. PMID: 33497585.)).