Evidence map›Paper›PMID 38652234›Full record

ArticleTranslational stroke research2025

Haptoglobin Attenuates Cerebrospinal Fluid Hemoglobin-Induced Neurological Deterioration in Sheep.

Bart R Thomson, Nina Schwendinger, Katrin Beckmann, Thomas Gentinetta, Daniel Couto, Sandra Wymann, Valérie Verdon, Raphael M Buzzi, Kevin Akeret, Peter W Kronen and 6 more

Open access · hybridAbstract read
In one paragraph

Article in Translational stroke research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
2.9field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 9 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 1 institution in 1 country.

Bart R ThomsonDepartment of Neurosurgery, Clinical Neuroscience Center, Universitätsspital and University of Zurich, Zurich, Switzerland.ORCID http://orcid.org/0000-0002-3073-9821
Nina SchwendingerDepartment of Neurosurgery, Clinical Neuroscience Center, Universitätsspital and University of Zurich, Zurich, Switzerland.
Katrin BeckmannNeurology Service, Department of Small Animals, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.ORCID http://orcid.org/0000-0002-1823-7845
Thomas GentinettaCSL Biologics Research Centre, Swiss Institute for Translational and Entrepreneurial Medicine, CSL, sitem-insel, Bern, Switzerland.
Daniel CoutoCSL Biologics Research Centre, Swiss Institute for Translational and Entrepreneurial Medicine, CSL, sitem-insel, Bern, Switzerland.
Sandra WymannCSL Biologics Research Centre, Swiss Institute for Translational and Entrepreneurial Medicine, CSL, sitem-insel, Bern, Switzerland.
Valérie VerdonCSL Biologics Research Centre, Swiss Institute for Translational and Entrepreneurial Medicine, CSL, sitem-insel, Bern, Switzerland.
Raphael M BuzziDivision of Internal Medicine, Universitätsspital and University of Zurich, Zurich, Switzerland.ORCID http://orcid.org/0000-0002-9584-3590
Kevin AkeretDepartment of Neurosurgery, Clinical Neuroscience Center, Universitätsspital and University of Zurich, Zurich, Switzerland.ORCID http://orcid.org/0000-0002-5946-4999
Peter W KronenVeterinary Anaesthesia Services - International, Winterthur, Switzerland.
Eva M WeinbergerDepartment of Neurosurgery, Clinical Neuroscience Center, Universitätsspital and University of Zurich, Zurich, Switzerland.
Ulrike HeldDepartment of Biostatistics and Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.ORCID http://orcid.org/0000-0003-3105-5840
Frauke SeehusenLaboratory of Animal Model Pathology, Institute of Veterinary Pathology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.ORCID http://orcid.org/0000-0001-6701-7868
Henning RichterCenter for Applied Biotechnology and Molecular Medicine (CABMM), University of Zurich, Zurich, Switzerland.ORCID http://orcid.org/0000-0003-3696-6993
Dominik J Schaer *Division of Internal Medicine, Universitätsspital and University of Zurich, Zurich, Switzerland.ORCID http://orcid.org/0000-0002-6468-4013
Michael Hugelshofer *Department of Neurosurgery, Clinical Neuroscience Center, Universitätsspital and University of Zurich, Zurich, Switzerland. Michael.Hugelshofer@usz.ch.ORCID http://orcid.org/0000-0002-3057-0472
University of Zurich · CH

Funding

Innosuisse - Schweizerische Agentur für Innovationsförderung 19300.1Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung 197823Uniscientia Foundation 174-2020
6 · The paper itself

Abstract

Secondary brain injury (SBI) occurs with a lag of several days post-bleeding in patients with aneurysmal subarachnoid hemorrhage (aSAH) and is a strong contributor to mortality and long-term morbidity. aSAH-SBI coincides with cell-free hemoglobin (Hb) release into the cerebrospinal fluid. This temporal association and convincing pathophysiological concepts suggest that CSF-Hb could be a targetable trigger of SBI. However, sparse experimental evidence for Hb's neurotoxicity in vivo defines a significant research gap for clinical translation. We modeled the CSF-Hb exposure observed in aSAH patients in conscious sheep, which allowed us to assess neurological functions in a gyrencephalic species. Twelve animals were randomly assigned for 3-day bi-daily intracerebroventricular (ICV) injections of either Hb or Hb combined with the high-affinity Hb scavenger protein haptoglobin (Hb-Hp, CSL888). Repeated CSF sampling confirmed clinically relevant CSF-Hb concentrations. This prolonged CSF-Hb exposure over 3 days resulted in disturbed movement activity, reduced food intake, and impaired observational neuroscores. The Hb-induced neurotoxic effects were significantly attenuated when Hb was administered with equimolar haptoglobin. Preterminal magnetic resonance imaging (MRI) showed no CSF-Hb-specific structural brain alterations. In both groups, histology demonstrated an inflammatory response and revealed enhanced perivascular histiocytic infiltrates in the Hb-Hp group, indicative of adaptive mechanisms. Heme exposure in CSF and iron deposition in the brain were comparable, suggesting comparable clearance efficiency of Hb and Hb-haptoglobin complexes from the intracranial compartment. We identified a neurological phenotype of CSF-Hb toxicity in conscious sheep, which is rather due to neurovascular dysfunction than structural brain injury. Haptoglobin was effective at attenuating CSF-Hb-induced neurological deterioration, supporting its therapeutic potential.

Indexed as

HaptoglobinsHemoglobinsSubarachnoid HemorrhageAnimalsDisease Models, AnimalMaleSheepHaptoglobinsHemoglobinsCSF-HbHaptoglobinRepeated exposureTherapeutic benefit

Identifiers

PMID38652234
PMCPMC12045829
OpenAlexW4395047720

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.