Patients with suspected subarachnoid hemorrhage viewed glucose-regulated protein 78 (GRP 78) ve C/EBP homologous protein (CHOP)levels in the diagnosis and prognosis

Objective: The aim of this study was to determine the diagnostic and prognostic value of ER stress markers CHOP and GRP 78 proteins, as well as oxidative stress biomarkers total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI) levels measured in blood and cerebrospinal fluid (CSF) samples taken from patients admitted to the emergency department with suspected subarachnoid hemorrhage (SAH). Materials and methods: Patients admitted to the emergency department with the suspicion of SAH were included in this prospectively planned study. The patients were diagnosed with SAH or the diagnosis of SAH was excluded after procedures such as Computerized Brain Tomography (CT), Lumber Puncture (LP). Patients without SAH constituted the control group. Three-time blood and one-time CSF samples were collected from patients with SAH at the time they applied to the emergency department, at the 12th hour and at discharge. From the control group, blood and CSF samples were taken only at the time of admission. GRP 78, CHOP, TOS, TAS and OSI levels were studied from blood and/or CSF samples in both groups. Results: 88 patients (n=88) with SAH were in the control group with a median blood GRP 78 of 1.24 ng/mL (1.06-1.54), median TOS of 18.98 µmol/mL (11.84-28.32) and OSI median value of 2.33 (1.32-3.32). (n=43) CSF GRP 78 1.63 ng/mL (1.30-2.46), TOS median value 57.96 µmol/mL (39.75-77.56), OSI median 5.99 (3.97-8.20) were found to be statistically different (p< 0.001 for all three markers). The median CSF CHOP value of patients diagnosed with SAH is 174.14 pg/mL (74.43-481.46), the median TOS value is 10.05 µmol/mL (6.22 13.48), and the median OSI value is 2.30 (1.29-3.17). ) and the median CSF CHOP 22.93 pg/mL (19.58-31.26), TOS median value 3.18 µmol/mL (0.65-6.12), OSI median value 0.67 (0.16-2, 05) and the difference was statistically significant (p<0.001 for all three markers). In 37 patients (n=37) with SAH, blood GRP 78 median values measured at admission, 12th hour and at discharge were 1.35 ng/mL (1.08-1.58) and TAS median values were 1.07 mmol/mL. ) (0.99-1.32) (p=0.009; p=0.005). The median CSF OSI value in SAH patients with poor clinical outcome (Glaskow Outcome Score 1,2) is 1.82 (0.78-2.61) compared to the median CSF OSI value in SAH patients with good clinical outcome (Glaskow Outcome Score 3,4,5) 2,49 (1.83-4.38) was lower. This difference was statistically significant (p<0.026). When the mortality rates of deceased and surviving patients were compared, the median CSF OSI value in patients who died was found to be 1.82 (0.78 2.61) and 2.49 (1.83 4.38) lower than the median value of CSF OSI in patients who survived, and this difference was statistically significant. (p<0.026). Conclusion: According to the results of our study, it was concluded that blood GRP 78, TAS, TOS, OSI and CSF CHOP, TOS, OSI levels could be potential parameters for diagnosing SAH.