ORIGINAL RESEARCH article
Front. Neurol.
Sec. Neurological Biomarkers
Usability of serum P2X7 as a prognostic biomarker in acute supratentorial intracerebral hemorrhage: A two-center observational analytical study
Provisionally accepted
- 1Zhejiang Rongjun Hospital, Jiaxing, China
- 2Zhejiang Chinese Medical University, Hangzhou, China
- 3Westlake University School of Medicine, Hangzhou, China
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Background: P2X7 participates in neuroinflammation underlying acute brain injury. Here, we determined the prognostic role of serum P2X7 in acute intracerebral hemorrhage (ICH). Methods: In this two-center observational analytic study, serum P2X7 levels were measured at study entry of 95 controls, at admission of 196 patients with acute supratentorial ICH and also at other serial time points of 95 among all patients. Disease severity was assessed using the National Institutes of Health Stroke Scale (NIHSS) and hematoma volume. Neurological functional outcome was evaluated applying the modified Rankin Scale (mRS) at six months following ICH. Severity correlation and outcome association were determined by multivariable analysis. Results: Serum P2X7 levels were promptly increased upon admission of patients, peaked at day 3, and afterwards slowly decreased until day 10. Serum P2X7 levels of patients were significantly higher during 10 days than those of controls. Serum P2X7 levels were linearly related to NIHSS scores, hematoma volume, mRS scores and poor prognosis (mRS 3-6) under the restricted cubic spline, and their associations with serum P2X7 levels were still existent by adjusting for other confounding factors. Using sensitivity analysis, subgroup analysis and receiver operating characteristic (ROC) curve analysis, serum P2X7 levels were robustly related to poor prognosis. Applying calibration curve analysis, decision curve analysis, ROC curve analysis and model improvement rate analysis, combined model integrating serum P2X7 levels, NIHSS scores and hematoma volume performed well. Moreover, serum P2X7 levels partially mediated correlations of NIHSS scores and hematoma volume with poor prognosis. Conclusion: Increased serum P2X7 levels after ICH are significantly associated with disease severity and poor prognosis, and P2X7 levels may partially explain correlation of illness severity with ICH prognosis, substantializing serum P2X7 as a potential prognostic biomarker of ICH.
Keywords: P2X7, intracerebral hemorrhage, prognosis, severity, biomarkers
Received: 31 Aug 2025; Accepted: 10 Nov 2025.
Copyright: © 2025 Chen, Shan, Lu, Zheng, Dong, Sun, Zhong and Ying. 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: Guozheng Ying, 13586467616@139.com
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