AUTHOR=Wu Xiaoyu , Liu Ming , Yan Tian , Wang Zefan , Yu Wenhua , Du Quan , Hu Wei , Zheng Yongke , Zhang Zuyong , Wang Keyi , Dong Xiaoqiao 

TITLE=Plasma PRPC Levels Correlate With Severity and Prognosis of Intracerebral Hemorrhage

JOURNAL=Frontiers in Neurology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.913926

DOI=10.3389/fneur.2022.913926

ISSN=1664-2295

ABSTRACT=Background: Cellular prion protein (PRPC) exerts brain protective effects. We determined relationship between plasma PRPC levels and disease severity plus clinical outcome after acute intracerebral hemorrhage (ICH).
Methods: A total of 138 ICH patients and 138 healthy controls were included in this prospective, observational study. Hematoma volume and Glasgow coma scale (GCS) score were used to assess disease severity. Glasgow outcome scale (GOS) scores 1-3 and 4-5 at 90 days after stroke were defined as poor outcome and good outcome respectively. Using multivariate analysis, we discerned relation of plasma PRPC levels to disease severity and poor outcome. Receiver operating characteristic curve was built to evaluate the prognostic predictive capability.
Results: Plasma PRPC levels in ICH patients were significantly higher than those in healthy controls (median, 4.20 vs 2.02 ng/ml; P<0.001), and were independently correlated with GCS score (r=-0.645, P<0.001) and hematoma volume (r=0.627, P<0.001). Plasma PRPC levels were highly correlated with GOS score (r=-0.762, P<0.001), and were substantially higher in patients with poor outcome than in those with good outcome. Using maximum Youden index, plasma PRPC levels >3.893 ng/ml distinguished the risk of poor outcome at 90 days, with a sensitivity of 86.4% and a specificity of 65.8% (area under curve, 0.809; 95% confidence interval, 0.737-0.881, P<0.001). Plasma PRPC levels >3.893 ng/ml was independently associated with poor 90-day outcome with odds ratio of 12.278 (95% confidence interval, 5.101-29.554).
Conclusion: Elevated plasma PRPC levels are significantly associated with disease severity and poor 90-day outcome in ICH patients, indicating that plasma PRPC may be used as a potential prognostic biomarker after ICH.