Correlation of F4-neuroprostanes levels in cerebrospinal fluid with outcome of aneurysmal subarachnoid hemorrhage in humans

Abstract Aneurysmal subarachnoid hemorrhage (aSAH) is one type of hemorrhagic stroke in humans. F 2 -isoprostanes (F 2 -IsoPs) and F 4 -neuroprostanes (F 4 -NPs), derived from arachidonic acid and docosahexaenoic acid (DHA), respectively, are specific markers of lipid peroxidation. We previously demonstrated that F 2 -IsoPs levels in cerebrospinal fluid (CSF) of aSAH patients positively correlated with poor clinical conditions. In this work, we refined F 4 -NPs analysis and investigated the role of potential oxidative damage to neurons in aSAH patients by detecting F 4 -NPs in CSF. [ 2 H 4 ]-15-F 2t -IsoP, rather than [ 18 O 2 ]-17-F 4c -NP or [ 2 H 4 ]-PGF 2α , was used as the internal standard for F 4 -NPs analysis. One problem of the use of [ 18 O 2 ]-17-F 4c -NP was the potential interference resulting from F 2 -dihomo-IsoPs in CSF. CSF specimens of 15 aSAH patients for up to 10 days and those of 12 non-aSAH controls were analyzed. First day, mean, and peak levels of F 4 -NPs were all significantly higher in aSAH patients than in controls and correlated with the Fisher Scale and 3-month Glasgow Outcome Scale, but only mean levels of F 4 -NPs correlated with Hunt and Hess Grade. The results first demonstrate oxidative damage to DHA in brain tissue following aSAH and suggest that F 4 -NPs in CSF could be a better predictor for outcome of aSAH than F 2 -IsoPs at early time points.