Delayed cerebral ischemia associated with surgery for pituitary macroadenomas that express elevated levels of PACAP

Dominic A. Siler; Kate U. Rosen; Stephen G. Bowden; Andrew Y. Powers; Jesse J. Liu; Aclan Dogan; Holly E. Hinson; Maria Fleseriu; Randy L. Woltjer; Justin S. Cetas

doi:10.1016/j.hest.2022.05.003

Delayed cerebral ischemia associated with surgery for pituitary macroadenomas that express elevated levels of PACAP

Dominic A. Siler, Kate U. Rosen, Stephen G. Bowden, Andrew Y. Powers, Jesse J. Liu, Aclan Dogan, Holly E. Hinson, Maria Fleseriu, Randy L. Woltjer, Justin S. Cetas

Research output: Contribution to journal › Article › peer-review

Abstract

Delayed cerebral ischemia (DCI) and cerebral vasospasm (VS) are rare but serious post-operative complications after surgery for pituitary macroadenomas; the mechanism of which are poorly understood. Pituitary adenylate cyclase-activating polypeptide (PACAP) is a vasoactive neuropeptide expressed in pituitary adenomas and may play a role in DCI/VS. The aim of this case-control study was to investigate the association between tumor expression of PACAP and DCI/VS following pituitary surgery. Tumor tissue from five patients with DCI/VS following pituitary surgery and nine matched controls were evaluated for PACAP expression by immunohistochemistry. Nuclear PACAP expression was significantly elevated in patients with DCI/VS following pituitary surgery compared to controls (0.396 ± 0.0.16 a.u. vs 0.093 ± 0.04 a.u, p < 0.0001). There was a positive linear relationship between nuclear PACAP expression and pre-operative tumor volume (r² = 0.41, p < 0.02) with a significant difference in slopes between the DCI/VS group compared to controls (y = x(5.0 × 10⁻³), r² = 0.76 vs y = x(7.4 × 10⁻⁴), r² = 0.07, p < 0.05). Elevated levels of tumor PACAP expression is associated with DCI/VS following pituitary surgery and may have a role in tumor growth. PACAP signaling may play a role the development of DCI, but further studies are needed.

Original language	English (US)
Pages (from-to)	1-5
Number of pages	5
Journal	Brain Hemorrhages
Volume	4
Issue number	1
DOIs	https://doi.org/10.1016/j.hest.2022.05.003
State	Published - Mar 2023

Keywords

Delayed cerebral ischemia
PACAP
Pituitary macroadenoma
Vasospasm

ASJC Scopus subject areas

Surgery
Neuroscience (miscellaneous)
Neurology
Clinical Neurology

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10.1016/j.hest.2022.05.003

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title = "Delayed cerebral ischemia associated with surgery for pituitary macroadenomas that express elevated levels of PACAP",

abstract = "Delayed cerebral ischemia (DCI) and cerebral vasospasm (VS) are rare but serious post-operative complications after surgery for pituitary macroadenomas; the mechanism of which are poorly understood. Pituitary adenylate cyclase-activating polypeptide (PACAP) is a vasoactive neuropeptide expressed in pituitary adenomas and may play a role in DCI/VS. The aim of this case-control study was to investigate the association between tumor expression of PACAP and DCI/VS following pituitary surgery. Tumor tissue from five patients with DCI/VS following pituitary surgery and nine matched controls were evaluated for PACAP expression by immunohistochemistry. Nuclear PACAP expression was significantly elevated in patients with DCI/VS following pituitary surgery compared to controls (0.396 ± 0.0.16 a.u. vs 0.093 ± 0.04 a.u, p < 0.0001). There was a positive linear relationship between nuclear PACAP expression and pre-operative tumor volume (r2 = 0.41, p < 0.02) with a significant difference in slopes between the DCI/VS group compared to controls (y = x(5.0 × 10−3), r2 = 0.76 vs y = x(7.4 × 10−4), r2 = 0.07, p < 0.05). Elevated levels of tumor PACAP expression is associated with DCI/VS following pituitary surgery and may have a role in tumor growth. PACAP signaling may play a role the development of DCI, but further studies are needed.",

keywords = "Delayed cerebral ischemia, PACAP, Pituitary macroadenoma, Vasospasm",

author = "Siler, {Dominic A.} and Rosen, {Kate U.} and Bowden, {Stephen G.} and Powers, {Andrew Y.} and Liu, {Jesse J.} and Aclan Dogan and Hinson, {Holly E.} and Maria Fleseriu and Woltjer, {Randy L.} and Cetas, {Justin S.}",

note = "Publisher Copyright: {\textcopyright} 2022",

year = "2023",

month = mar,

doi = "10.1016/j.hest.2022.05.003",

language = "English (US)",

volume = "4",

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journal = "Brain Hemorrhages",

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TY - JOUR

T1 - Delayed cerebral ischemia associated with surgery for pituitary macroadenomas that express elevated levels of PACAP

AU - Siler, Dominic A.

AU - Rosen, Kate U.

AU - Bowden, Stephen G.

AU - Powers, Andrew Y.

AU - Liu, Jesse J.

AU - Dogan, Aclan

AU - Hinson, Holly E.

AU - Fleseriu, Maria

AU - Woltjer, Randy L.

AU - Cetas, Justin S.

PY - 2023/3

Y1 - 2023/3

N2 - Delayed cerebral ischemia (DCI) and cerebral vasospasm (VS) are rare but serious post-operative complications after surgery for pituitary macroadenomas; the mechanism of which are poorly understood. Pituitary adenylate cyclase-activating polypeptide (PACAP) is a vasoactive neuropeptide expressed in pituitary adenomas and may play a role in DCI/VS. The aim of this case-control study was to investigate the association between tumor expression of PACAP and DCI/VS following pituitary surgery. Tumor tissue from five patients with DCI/VS following pituitary surgery and nine matched controls were evaluated for PACAP expression by immunohistochemistry. Nuclear PACAP expression was significantly elevated in patients with DCI/VS following pituitary surgery compared to controls (0.396 ± 0.0.16 a.u. vs 0.093 ± 0.04 a.u, p < 0.0001). There was a positive linear relationship between nuclear PACAP expression and pre-operative tumor volume (r2 = 0.41, p < 0.02) with a significant difference in slopes between the DCI/VS group compared to controls (y = x(5.0 × 10−3), r2 = 0.76 vs y = x(7.4 × 10−4), r2 = 0.07, p < 0.05). Elevated levels of tumor PACAP expression is associated with DCI/VS following pituitary surgery and may have a role in tumor growth. PACAP signaling may play a role the development of DCI, but further studies are needed.

AB - Delayed cerebral ischemia (DCI) and cerebral vasospasm (VS) are rare but serious post-operative complications after surgery for pituitary macroadenomas; the mechanism of which are poorly understood. Pituitary adenylate cyclase-activating polypeptide (PACAP) is a vasoactive neuropeptide expressed in pituitary adenomas and may play a role in DCI/VS. The aim of this case-control study was to investigate the association between tumor expression of PACAP and DCI/VS following pituitary surgery. Tumor tissue from five patients with DCI/VS following pituitary surgery and nine matched controls were evaluated for PACAP expression by immunohistochemistry. Nuclear PACAP expression was significantly elevated in patients with DCI/VS following pituitary surgery compared to controls (0.396 ± 0.0.16 a.u. vs 0.093 ± 0.04 a.u, p < 0.0001). There was a positive linear relationship between nuclear PACAP expression and pre-operative tumor volume (r2 = 0.41, p < 0.02) with a significant difference in slopes between the DCI/VS group compared to controls (y = x(5.0 × 10−3), r2 = 0.76 vs y = x(7.4 × 10−4), r2 = 0.07, p < 0.05). Elevated levels of tumor PACAP expression is associated with DCI/VS following pituitary surgery and may have a role in tumor growth. PACAP signaling may play a role the development of DCI, but further studies are needed.

KW - Delayed cerebral ischemia

KW - PACAP

KW - Pituitary macroadenoma

KW - Vasospasm

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U2 - 10.1016/j.hest.2022.05.003

DO - 10.1016/j.hest.2022.05.003

M3 - Article

AN - SCOPUS:85131118407

SN - 2589-238X

VL - 4

SP - 1

EP - 5

JO - Brain Hemorrhages

JF - Brain Hemorrhages

IS - 1

ER -

Delayed cerebral ischemia associated with surgery for pituitary macroadenomas that express elevated levels of PACAP

Abstract

Keywords

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