AUTHOR=Zeiler Frederick A. , Thelin Eric Peter , Czosnyka Marek , Hutchinson Peter J. , Menon David K. , Helmy Adel 

TITLE=Cerebrospinal Fluid and Microdialysis Cytokines in Aneurysmal Subarachnoid Hemorrhage: A Scoping Systematic Review

JOURNAL=Frontiers in Neurology

VOLUME=8

YEAR=2017

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2017.00379

DOI=10.3389/fneur.2017.00379

ISSN=1664-2295

ABSTRACT=<sec id="ST1"><title>Objective</title><p>To perform two scoping systematic reviews of the literature on cytokine measurement in cerebral microdialysis (CMD) and cerebrospinal fluid (CSF) in aneurysmal subarachnoid hemorrhage (SAH) patients, aiming to summarize the evidence relating cytokine levels to pathophysiology, disease progression, and outcome.</p></sec><sec id="ST2"><title>Methods</title><p>Two separate systematic reviews were conducted: one for CMD cytokines and the second for CSF cytokines.</p></sec><sec id="ST3"><title>Data sources</title><p>Articles from MEDLINE, BIOSIS, EMBASE, Global Health, Scopus, Cochrane Library (inception to October 2016), reference lists of relevant articles, and gray literature were searched.</p></sec><sec id="ST4"><title>Study selection</title><p>Two reviewers independently identified all manuscripts utilizing predefined inclusion/exclusion criteria. A two-tier filter of references was conducted.</p></sec><sec id="ST5"><title>Data extraction</title><p>Patient demographic and study data were extracted to tables.</p></sec><sec id="ST6"><title>Results</title><p>There were 9 studies identified describing the analysis of cytokines <italic>via</italic> CMD in 246 aneurysmal SAH patients. Similarly, 20 studies were identified describing the analysis of CSF cytokines in 630 patients. The two scoping systematic reviews demonstrated the following: (1) limited literature available on CMD cytokine measurement in aneurysmal SAH with some preliminary data supporting feasibility of measurement and potential association between interleukin (IL)-6 and patient outcome. (2) Various CSF measured cytokines may be associated with patient outcome at 3–6 months, including IL-1ra, IL-6, IL-8, and tumor necrosis factor-alpha. (3) There is a small literature body supporting an association between acute/subacute CSF transforming growth factor levels and the development of chronic hydrocephalus at 2–3 months.</p></sec><sec id="ST7"><title>Conclusion</title><p>The evaluation of CMD and CSF cytokines is an emerging area of the literature in aneurysmal SAH. Further large prospective multicenter studies on cytokines in CMD and CSF need to be conducted.</p></sec>