ORIGINAL RESEARCH article
Front. Neurol.
Sec. Endovascular and Interventional Neurology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1554809
Dexmedetomidine Reduces In-Hospital Mortality in Aneurysmal Subarachnoid Hemorrhage Patients by Modulating Three Key Genes and Inflammatory Pathways: Insights from Clinical and Bioinformatics Analyses
Provisionally accepted
- The Affiliated Lihuili Hospital of Ningbo University, Ningbo, Zhejiang Province, China
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Background: Aneurysmal subarachnoid hemorrhage (aSAH) is a cerebrovascular disease with high mortality. Dexmedetomidine has a neuroprotective effect. This study aimed to explore the clinical and molecular association between dexmedetomidine and in-hospital mortality of aSAH.Patients with aSAH in the MIMIC-IV database were included and divided into non-inhospital mortality and in-hospital mortality groups. Two machine learning algorithms random forest (RF) and XGBoost ranked treatment variables, and overlapping variables between these two algorithms were selected to evaluate their prognosis value for aSAH. Bioinformatics approaches, including DEG analysis, pathway enrichment, immune infiltration, and GSEA, explored potential mechanisms. Molecular docking assessed interactions between dexmedetomidine and identified hub genes.Results: A total of 505 individuals with aSAH were included in this study, with 114 dying in-hospital.Patients in the in-hospital mortality group exhibited older age, higher SAPS II scores, and altered physiological parameters. Dexmedetomidine was the most influential treatment variable, significantly associated with reduced in-hospital mortality. Bioinformatics identified three hub genes (MyD88, AR, AREG) related to aSAH and dexmedetomidine. These hub genes showed promising diagnostic accuracy in aSAH, with all AUC values over 0.67. Immune infiltration and GSEA highlighted the involvement of hub genes in inflammation and immune regulation. Molecular docking revealed AR as a direct target of dexmedetomidine (binding energy = -5.68 kcal/mol).Dexmedetomidine is correlated with reduced in-hospital mortality in aSAH, potentially by regulating AR and immune pathways. These findings highlight AR as a promising therapeutic target of dexmedetomidine for aSAH management.
Keywords: aneurysmal subarachnoid Hemorrhage, Dexmedetomidine, In-hospital mortality, Inflammation, immune
Received: 03 Jan 2025; Accepted: 15 Jun 2025.
Copyright: © 2025 Li, Wang, Zhang and Hu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Li-hong Hu, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, Zhejiang Province, China
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