array:24 [
  "pii" => "S0210569116302583"
  "issn" => "02105691"
  "doi" => "10.1016/j.medin.2016.10.013"
  "estado" => "S300"
  "fechaPublicacion" => "2017-11-01"
  "aid" => "1006"
  "copyright" => "Elsevier España, S.L.U. y SEMICYUC"
  "copyrightAnyo" => "2016"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "fla"
  "cita" => "Med Intensiva. 2017;41:468-74"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 2250
    "formatos" => array:3 [
      "EPUB" => 218
      "HTML" => 1340
      "PDF" => 692
    ]
  ]
  "Traduccion" => array:1 [
    "en" => array:19 [
      "pii" => "S2173572717301741"
      "issn" => "21735727"
      "doi" => "10.1016/j.medine.2016.10.013"
      "estado" => "S300"
      "fechaPublicacion" => "2017-11-01"
      "aid" => "1006"
      "copyright" => "Elsevier España, S.L.U. and SEMICYUC"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "fla"
      "cita" => "Med Intensiva. 2017;41:468-74"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 1531
        "formatos" => array:3 [
          "EPUB" => 191
          "HTML" => 836
          "PDF" => 504
        ]
      ]
      "en" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
        "titulo" => "Urotensinergic system genes in experimental subarachnoid hemorrhage"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "tieneResumen" => array:2 [
          0 => "en"
          1 => "es"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "468"
            "paginaFinal" => "474"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "es" => array:1 [
            "titulo" => "El sistema urotensin&#233;rgico en un modelo experimental de hemorragia subaracnoidea"
          ]
        ]
        "contieneResumen" => array:2 [
          "en" => true
          "es" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0010"
            "etiqueta" => "Figure 2"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr2.jpeg"
                "Alto" => 1136
                "Ancho" => 3404
                "Tamanyo" => 196104
              ]
            ]
            "descripcion" => array:1 [
              "en" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">ROC analysis comparing sensitivity to 1-specificity of serum U-II on fifth day &#40;A&#41;&#44; URP mRNA &#40;B&#41; and UT mRNA &#40;C&#41; to discriminate SAH rats&#46; &#40;A&#58; AUC<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;691 &#91;95&#37;CI&#58; 0&#46;565&#8211;0&#46;817&#93;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;008&#59; AUC<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;706 &#91;95&#37;CI&#58; 0&#46;543&#8211;0&#46;868&#93; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;038&#59; C&#58; AUC<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;713 &#91;95&#37;CI&#58; 0&#46;540&#8211;0&#46;887&#93; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;046&#41;&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "M&#46;&#193;&#46; Mu&#241;oz-S&#225;nchez, A&#46; Rodr&#237;guez-Rodr&#237;guez, J&#46;J&#46; Egea-Guerrero, E&#46; Gordillo-Escobar, &#193;&#46; Vilches-Arenas, A&#46; Carrillo-Vico, J&#46;M&#46; Guerrero, F&#46; Murillo-Cabezas"
            "autores" => array:8 [
              0 => array:2 [
                "nombre" => "M&#46;&#193;&#46;"
                "apellidos" => "Mu&#241;oz-S&#225;nchez"
              ]
              1 => array:2 [
                "nombre" => "A&#46;"
                "apellidos" => "Rodr&#237;guez-Rodr&#237;guez"
              ]
              2 => array:2 [
                "nombre" => "J&#46;J&#46;"
                "apellidos" => "Egea-Guerrero"
              ]
              3 => array:2 [
                "nombre" => "E&#46;"
                "apellidos" => "Gordillo-Escobar"
              ]
              4 => array:2 [
                "nombre" => "&#193;&#46;"
                "apellidos" => "Vilches-Arenas"
              ]
              5 => array:2 [
                "nombre" => "A&#46;"
                "apellidos" => "Carrillo-Vico"
              ]
              6 => array:2 [
                "nombre" => "J&#46;M&#46;"
                "apellidos" => "Guerrero"
              ]
              7 => array:2 [
                "nombre" => "F&#46;"
                "apellidos" => "Murillo-Cabezas"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S0210569116302583"
          "doi" => "10.1016/j.medin.2016.10.013"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569116302583?idApp=WMIE"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572717301741?idApp=WMIE"
      "url" => "/21735727/0000004100000008/v1_201710301314/S2173572717301741/v1_201710301314/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S0210569116302480"
    "issn" => "02105691"
    "doi" => "10.1016/j.medin.2016.10.008"
    "estado" => "S300"
    "fechaPublicacion" => "2017-11-01"
    "aid" => "999"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; y SEMICYUC"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Med Intensiva. 2017;41:475-82"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2427
      "formatos" => array:3 [
        "EPUB" => 165
        "HTML" => 1592
        "PDF" => 670
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
      "titulo" => "Reduced thrombin activatable fibrinolysis inhibitor and enhanced proinflammatory cytokines in acute coronary syndrome"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "475"
          "paginaFinal" => "482"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Reducci&#243;n del inhibidor de la fibrin&#243;lisis activado por trombina y aumento de las citocinas proinflamatorias en pacientes son s&#237;ndrome coronario agudo"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 2560
              "Ancho" => 2550
              "Tamanyo" => 248284
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Relationship between serum level of TAFI and pro-inflammatory cytokines and acute phase proteins in patients with acute coronary syndrome&#46; A significant negative correlation existed in acute coronary syndrome patients between the serum level of TAFI and pro-inflammatory cytokines and acute phase proteins&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "H&#46; Pang, C&#46; Zhang, F&#46; Liu, X&#46; Gong, X&#46; Jin, C&#46; Su"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "H&#46;"
              "apellidos" => "Pang"
            ]
            1 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Zhang"
            ]
            2 => array:2 [
              "nombre" => "F&#46;"
              "apellidos" => "Liu"
            ]
            3 => array:2 [
              "nombre" => "X&#46;"
              "apellidos" => "Gong"
            ]
            4 => array:2 [
              "nombre" => "X&#46;"
              "apellidos" => "Jin"
            ]
            5 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Su"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S217357271730173X"
        "doi" => "10.1016/j.medine.2016.10.012"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217357271730173X?idApp=WMIE"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569116302480?idApp=WMIE"
    "url" => "/02105691/0000004100000008/v1_201710301105/S0210569116302480/v1_201710301105/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S0210569117300013"
    "issn" => "02105691"
    "doi" => "10.1016/j.medin.2016.12.002"
    "estado" => "S300"
    "fechaPublicacion" => "2017-11-01"
    "aid" => "1016"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; y SEMICYUC"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Med Intensiva. 2017;41:461-7"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 6971
      "formatos" => array:3 [
        "EPUB" => 195
        "HTML" => 5723
        "PDF" => 1053
      ]
    ]
    "es" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">ORIGINAL</span>"
      "titulo" => "Efecto de la FiO<span class="elsevierStyleInf">2</span> sobre la medici&#243;n del VO<span class="elsevierStyleInf">2</span> y la VCO<span class="elsevierStyleInf">2</span> con el monitor metab&#243;lico E-COVX"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "461"
          "paginaFinal" => "467"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Effect of FiO<span class="elsevierStyleInf">2</span> in the measurement of VO<span class="elsevierStyleInf">2</span> and VCO<span class="elsevierStyleInf">2</span> using the E-COXV metabolic monitor"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figura 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 2590
              "Ancho" => 1637
              "Tamanyo" => 171340
            ]
          ]
          "descripcion" => array:1 [
            "es" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Representaci&#243;n gr&#225;fica&#44; seg&#250;n Bland y Altman&#44; de las diferencias en porcentaje de los 2 valores consecutivos del V&#729;O2 y la V&#729;CO2 de cada paciente medidos a una FiO<span class="elsevierStyleInf">2</span> de 0&#44;4 respecto al valor medio de ambas mediciones en mL&#47;min&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "M&#46; Ferreruela, J&#46;M&#46; Raurich, J&#46;A&#46; Llompart-Pou, A&#46; Colomar, I&#46; Ayestar&#225;n"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Ferreruela"
            ]
            1 => array:2 [
              "nombre" => "J&#46;M&#46;"
              "apellidos" => "Raurich"
            ]
            2 => array:2 [
              "nombre" => "J&#46;A&#46;"
              "apellidos" => "Llompart-Pou"
            ]
            3 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Colomar"
            ]
            4 => array:2 [
              "nombre" => "I&#46;"
              "apellidos" => "Ayestar&#225;n"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2173572717301674"
        "doi" => "10.1016/j.medine.2017.08.007"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572717301674?idApp=WMIE"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569117300013?idApp=WMIE"
    "url" => "/02105691/0000004100000008/v1_201710301105/S0210569117300013/v1_201710301105/es/main.assets"
  ]
  "en" => array:20 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
    "titulo" => "Urotensinergic system genes in experimental subarachnoid hemorrhage"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "468"
        "paginaFinal" => "474"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "M&#46;&#193;&#46; Mu&#241;oz-S&#225;nchez, A&#46; Rodr&#237;guez-Rodr&#237;guez, J&#46;J&#46; Egea-Guerrero, E&#46; Gordillo-Escobar, &#193;&#46; Vilches-Arenas, A&#46; Carrillo-Vico, J&#46;M&#46; Guerrero, F&#46; Murillo-Cabezas"
        "autores" => array:8 [
          0 => array:3 [
            "nombre" => "M&#46;&#193;&#46;"
            "apellidos" => "Mu&#241;oz-S&#225;nchez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          1 => array:4 [
            "nombre" => "A&#46;"
            "apellidos" => "Rodr&#237;guez-Rodr&#237;guez"
            "email" => array:2 [
              0 => "rodriguezana13m&#64;gmail&#46;com"
              1 => "swroder&#95;an&#64;hotmail&#46;com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "J&#46;J&#46;"
            "apellidos" => "Egea-Guerrero"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "E&#46;"
            "apellidos" => "Gordillo-Escobar"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "&#193;&#46;"
            "apellidos" => "Vilches-Arenas"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "A&#46;"
            "apellidos" => "Carrillo-Vico"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">e</span>"
                "identificador" => "aff0025"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "J&#46;M&#46;"
            "apellidos" => "Guerrero"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">e</span>"
                "identificador" => "aff0025"
              ]
            ]
          ]
          7 => array:3 [
            "nombre" => "F&#46;"
            "apellidos" => "Murillo-Cabezas"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:5 [
          0 => array:3 [
            "entidad" => "Servicio de Urgencias&#44; Hospital Universitario Virgen del Roc&#237;o&#44; IBIS&#47;CSIC&#47;Universidad de Sevilla&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Cuidados Cr&#237;ticos&#44; Hospital Universitario Virgen del Roc&#237;o&#44; IBIS&#47;CSIC&#47;Universidad de Sevilla&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Servicio de Medicina Preventiva y Salud P&#250;blica&#44; Hospital Virgen Macarena&#44; Universidad de Sevilla&#44; Spain"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
          3 => array:3 [
            "entidad" => "Instituto de Biomedicina de Sevilla &#40;IBiS&#41;&#44; Hospital Universitario Virgen del Roc&#237;o&#47;CSIC&#47;Universidad de Sevilla&#44; Spain"
            "etiqueta" => "d"
            "identificador" => "aff0020"
          ]
          4 => array:3 [
            "entidad" => "Departamento de Bioquimica M&#233;dica&#44; Biolog&#237;a molecular e Inmunolog&#237;a&#44; Facultad de Medicina&#44; Universidad de Sevilla&#44; Spain"
            "etiqueta" => "e"
            "identificador" => "aff0025"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "El sistema urotensin&#233;rgico en un modelo experimental de hemorragia subaracnoidea"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1135
            "Ancho" => 3411
            "Tamanyo" => 162574
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">ROC analysis comparing sensitivity to 1-specificity of serum U-II on fifth day &#40;A&#41;&#44; URP mRNA &#40;B&#41; and UT mRNA &#40;C&#41; to discriminate SAH rats&#46; &#40;A&#58; AUC<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;691 &#91;95&#37;CI&#58; 0&#46;565&#8211;0&#46;817&#93;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;008&#59; AUC<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;706 &#91;95&#37;CI&#58; 0&#46;543&#8211;0&#46;868&#93; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;038&#59; C&#58; AUC<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;713 &#91;95&#37;CI&#58; 0&#46;540&#8211;0&#46;887&#93; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;046&#41;&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Spontaneous subarachnoid hemorrhage &#40;SAH&#41; has an annual incidence rate of 4&#8211;28 cases per 100&#44;000 people&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">1&#44;2</span></a> SAH accounts for about 80&#37; of all nontraumatic extravasated bleeding into the subarachnoid space&#44; 5&#37; of stroke deaths and over a quarter of potential life years lost due to stroke&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">1&#44;3&#44;4</span></a> Approximately 15&#37; of SAH patients die after aneurysmal rupture&#46; Another 25&#8211;50&#37; die within a month of the bleeding&#46; Of those who survive&#44; 40&#37; present disabling sequelae&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">5&#44;6</span></a> It is estimated that cerebral vasospasm &#40;CVS&#41; is responsible for neurological deterioration&#44; and even death&#44; in 15&#8211;20&#37; of patients with SAH&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">5&#44;7</span></a> CVS is characterized by diffuse and long-lasting arterial constriction&#46; Several vasoconstrictor proteins have been shown to contribute to this narrowing process&#46;<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">8&#8211;11</span></a> However&#44; Urotensin-II &#40;U-II&#41;&#44; defined as the most potent vasoconstrictor peptide in mammals according to Ames et al&#46; research study&#44; is not among these biomarkers&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">12</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">U-II is an 11-amino-acid peptide with a cysteine disulfide bond&#44; derived from the polypeptide precursor known as prepro-urotensin-II &#40;preproU-II&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">13</span></a> Proteolytic cleavage of the C-terminal fragment from this precursor is required for biological activity&#46; The result of this proteolysis is an undecapeptide with a cyclic hexapeptide sequence&#44; fundamental for this hormonal action&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">14</span></a> Once the active form of the peptide is generated&#44; U-II mediates its biological action by interacting with a specific plasma membrane G-protein coupled receptor identified as GRP14&#44; or UT&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">12</span></a> This receptor binds different U-II sequences&#44; including the U-II fragment &#40;4&#8211;11&#41; and U-II &#40;5&#8211;11&#41;&#44; as well as the urotensin-related peptide &#40;URP&#41;&#44; which derives from a different precursor&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">15</span></a> URP is shorter &#40;octapeptide&#41;&#44; but exhibits the cyclic hexapeptide core sequence&#46; U-II expression has been found throughout the heart&#44; kidney&#44; urogenital system and nervous system&#46;<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">16&#8211;18</span></a> Tian et al&#46; described its expression&#44; as well as UT expression&#44; in the cytoplasm of neurons and in vascular endothelial cells from rats&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">19</span></a> Our research group recently found that high doses of U-II &#40;10<span class="elsevierStyleHsp" style=""></span>&#956;M&#41; in intact rat cerebral arteries evoke arterial contraction&#46; However&#44; in depolarized vascular smooth muscle&#44; lower U-II concentrations &#40;0&#46;1 and 1<span class="elsevierStyleHsp" style=""></span>&#956;M&#41; cause dose-dependent arterial contraction&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">20</span></a> This effect could facilitate arterial CVS in vascular pathophysiological processes such as SAH&#44; where sustained depolarization is present&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">21</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The objective of the present study was to determine the normal range for U-II serum levels and analyze U-II serum and mRNA expression values for the urotensinergic system genes &#40;U-II&#44; URP and UT&#41; in an experimental murine model of SAH&#59; with the purpose of using these molecules as biomarkers of arterial vasoconstriction in SAH&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Materials and methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">Procedures were performed in the experimental operating room of the Biomedicine Institute of Seville &#40;Instituto de Biomedicina de Sevilla &#91;IBiS&#93;&#47;CSIC University of Seville&#41;&#44; at the Virgen del Roc&#237;o University Hospital&#44; Seville&#44; Spain&#46; This research project was overseen and approved by our hospital&#39;s Animal Experimentation Committee&#46; It met all the legal requirements and ethical standards for research established by current legislation &#40;Directive 2010&#47;63&#47;EU&#41;&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Animals and samples</span><p id="par0025" class="elsevierStylePara elsevierViewall">Wistar rats weighing 300&#8211;350<span class="elsevierStyleHsp" style=""></span>g were used&#46; The procedure was performed on males&#44; to eliminate the cyclic cardioprotective effects of the estrous cycle&#46; After the procedure&#44; the animals were housed in independent cages&#44; in a dry area away from infectious sources and surgical areas&#44; and kept on a 12&#58;12<span class="elsevierStyleHsp" style=""></span>h light&#47;dark cycle&#46; A stable room temperature was set between 23<span class="elsevierStyleHsp" style=""></span>&#176;C and 27<span class="elsevierStyleHsp" style=""></span>&#176;C&#46; Food and water was provided without restrictions&#44; before and after surgery&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Animals were anesthetized by intraperitoneal injection of the following preparation&#58; 50<span class="elsevierStyleHsp" style=""></span>mg ketamine hydrochloride &#40;Ketolar<span class="elsevierStyleSup">&#169;</span>&#44; Pfizer&#59; 50<span class="elsevierStyleHsp" style=""></span>mg&#47;mL&#41;&#44; 2<span class="elsevierStyleHsp" style=""></span>mL Xylazine &#40;Rompun<span class="elsevierStyleSup">&#169;</span> 2&#37;&#44; Bayer&#59; 20<span class="elsevierStyleHsp" style=""></span>mg&#47;mL&#41; and 1<span class="elsevierStyleHsp" style=""></span>mg atropine &#40;Atropina Bayer<span class="elsevierStyleSup">&#169;</span>&#44; 1<span class="elsevierStyleHsp" style=""></span>mg&#47;mL&#41;&#46; The optimal dose for analgesia and sedation was established at 0&#46;025<span class="elsevierStyleHsp" style=""></span>mL per gram of body weight&#46;<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">20&#44;22</span></a> Adequate depth of anesthesia in the spontaneously breathing rats was ensured by the absence of corneal reflex and withdrawal reflex after pressure on the hind legs&#46; Cardiac and respiratory rates were measured during the procedure&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Procedures for the two animal models</span><p id="par0035" class="elsevierStylePara elsevierViewall">SAH group&#58; The SAH model was executed as previously described by our research group&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">23</span></a> The animals were put in prone position with their heads fixed to a stereotaxic frame &#40;Stoelting<span class="elsevierStyleSup">&#169;</span>&#41;&#46; A non-heparinized syringe was used to obtain 100<span class="elsevierStyleHsp" style=""></span>&#956;L of autologous blood from the proximal part of the tail &#40;1<span class="elsevierStyleHsp" style=""></span>mL BD Plastipak<span class="elsevierStyleSup">&#169;</span>&#41;&#46; This was injected into the intracisternal space via cisterna magna&#44; after extraction of the same volume of CSF&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Sham group&#58; Identical procedures were executed with one exception&#58; 100<span class="elsevierStyleHsp" style=""></span>&#956;L of isotonic saline was administered in place of blood after CSF extraction&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">On day 5 post-surgery&#44; the animals were sacrificed with a lethal dose of ketamine hydrochloride &#40;0&#46;01<span class="elsevierStyleHsp" style=""></span>mL&#47;kg&#41; &#40;Ketolar<span class="elsevierStyleSup">&#169;</span>&#44; Pfizer&#44; 50<span class="elsevierStyleHsp" style=""></span>mg&#47;mL&#41; injected into the intraperitoneal cavity&#46;<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">20&#44;22</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Blood draws were performed on day 1 prior to the execution of the animal model and on day 5&#44; prior to the sacrifice&#46; Animals were placed in a supine position for blood sample collection&#46; Using binocular lens&#44; an inguinal incision was made&#44; freeing up layers of the abdominal wall&#44; to expose the femoral vein&#46; For serum isolation&#44; 0&#46;8<span class="elsevierStyleHsp" style=""></span>mL of venous blood was collected in a VACUETTE<span class="elsevierStyleSup">&#174;</span> serum separator tube containing aprotinin &#40;0&#46;6<span class="elsevierStyleHsp" style=""></span>TIU&#47;mL of blood&#41;&#46; An additional extraction was performed on day 5&#44; after the lethal injection of ketamine&#46; Each animal&#39;s entire blood volume was extracted by cardiac puncture and collected in a VACUTAINER<span class="elsevierStyleSup">&#174;</span> CPT&#8482; tube &#40;Cell Preparation Tube&#41; &#40;BD&#44; Franklin Lakes&#44; NJ&#41;&#44; for mononuclear cell isolation&#46; Brains were removed and examined macroscopically to analyze the presence or absence of pathological findings&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">The VACUETTE<span class="elsevierStyleSup">&#174;</span> tubes were centrifuged at 1600<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">g</span> for 10<span class="elsevierStyleHsp" style=""></span>min at room temperature&#46; The separated sera were frozen in aliquots at &#8722;80<span class="elsevierStyleHsp" style=""></span>&#176;C prior to their analysis&#46; VACUTAINER<span class="elsevierStyleSup">&#174;</span> CPT&#8482; tubes were centrifuged at 1900<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">g</span> for 20<span class="elsevierStyleHsp" style=""></span>min at room temperature&#46; Mononuclear cells were collected from the processed CPT by gently inverting the collection tube several times&#44; and drawing off the mononuclear cells containing plasma with a pipette into a tube containing 10<span class="elsevierStyleHsp" style=""></span>mL of saline&#46; Following the manufacturer&#39;s instructions&#44; this tube was centrifuged at 300<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">g</span> for 5<span class="elsevierStyleHsp" style=""></span>min at 4<span class="elsevierStyleHsp" style=""></span>&#176;C&#46; Mononuclear cells were washed twice with saline as described in the previous step and finally pelleted by centrifugation at 16&#44;000<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">g</span> for 5<span class="elsevierStyleHsp" style=""></span>min at 4<span class="elsevierStyleHsp" style=""></span>&#176;C in a sterile Eppendorf tube&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Measurement of Urotensin-II serum levels</span><p id="par0060" class="elsevierStylePara elsevierViewall">U-II serum levels were measured by fluorescent enzyme immunoassay &#40;EIA&#41; produced by Phoenix Pharmaceuticals&#44; Inc&#46; For peptide extraction&#44; serum samples were previously loaded into a SEP-COLUMN containing 200<span class="elsevierStyleHsp" style=""></span>mg of C18 &#40;Cat&#46; No&#46; RK-SEPCOL-1&#41; following the manufacturer&#39;s indications&#46; Data on cross-reactivity was provided by the manufacturer&#58; 100&#37; with rat UT-II and 11&#37; with URP&#46; No cross-reactivity was found with rat endothelin-I&#44; C-type natriuretic peptide-22&#44; calcitonin gene-related peptide&#44; adrenomedullin&#44; atrial natriuretic peptide&#44; bradykinin&#44; angiotensin II or brain natriuretic peptide&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Nucleic acid extraction</span><p id="par0065" class="elsevierStylePara elsevierViewall">The pelleted mononuclear cells were lysed by repetitive pipetting with 750<span class="elsevierStyleHsp" style=""></span>&#956;L of TRIsure&#8482; Isolation Reagent &#40;Bioline&#41;&#46; The samples were incubated for 5<span class="elsevierStyleHsp" style=""></span>min at room temperature to ensure the complete dissociation of nucleoprotein complexes&#46; We then added 300<span class="elsevierStyleHsp" style=""></span>&#956;L of chloroform and vigorously shook the Eppendorf for 15<span class="elsevierStyleHsp" style=""></span>s&#46; This step was followed by 2&#8211;15<span class="elsevierStyleHsp" style=""></span>min of incubation on ice&#44; and 15<span class="elsevierStyleHsp" style=""></span>min of centrifugation at 12&#44;000<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">g</span>&#44; to separate the solution into three phases&#46; The upper colorless phase contained the RNA fraction&#8212;it was carefully removed and drawn into an Eppendorf containing 500<span class="elsevierStyleHsp" style=""></span>&#956;L of isopropanol&#46; After 5&#8211;10<span class="elsevierStyleHsp" style=""></span>min of incubation&#44; samples of this new mixture were incubated for 2<span class="elsevierStyleHsp" style=""></span>h at &#8722;20<span class="elsevierStyleHsp" style=""></span>&#176;C and then centrifuged at 12&#44;000<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">g</span> for 10<span class="elsevierStyleHsp" style=""></span>min at 4<span class="elsevierStyleHsp" style=""></span>&#176;C to form an RNA pellet&#46; This pellet was isolated and washed twice with 1<span class="elsevierStyleHsp" style=""></span>mL of ethanol&#46; Finally&#44; the pellet was resuspended in 30<span class="elsevierStyleHsp" style=""></span>&#956;L of RNAs-free water&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Prior to cDNA synthesis&#44; extracted RNA concentration and purity &#40;OD<span class="elsevierStyleInf">260</span>&#47;OD<span class="elsevierStyleInf">280</span>&#41; were quantified by spectrophotometry at 260&#8211;280<span class="elsevierStyleHsp" style=""></span>nm &#40;NanoDrop&#44; PeqLab Technology&#44; Erlangen&#44; Germany&#41;&#46; An OD<span class="elsevierStyleInf">260</span>&#47;OD<span class="elsevierStyleInf">280</span> ratio between 1&#46;7 and 2&#46;0 indicates reasonable RNA purity&#46; Samples above or below this purity range were discarded&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">One &#956;g of RNA from each sample was retrotranscripted into cDNA with the QuantiTect Reverse Transcription Kit &#40;Qiagen&#41;&#44; following the manufacturer&#39;s protocol&#46; This protocol includes treating the samples with gDNA wipeout buffer&#44; to eliminate genomic DNA contamination&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Real-time PCR</span><p id="par0080" class="elsevierStylePara elsevierViewall">To conduct a polymerase chain reaction &#40;PCR&#41;&#44; half of the lymphocyte samples were selected from both animal groups by applying block randomization&#46; This procedure also ensured that the two subgroups were of equal size&#46; The remaining samples were used for other analyses &#40;unpublished&#41;&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Commercially available Real-Time ready assays for the target genes &#40;U-II&#44; URP and UT&#41;&#44; and the 18 ribosomal RNA housekeeping genes&#44; were obtained lyophilized in 384-well PCR plates&#44; with forward and reverse primers &#40;400<span class="elsevierStyleHsp" style=""></span>nM&#41; and fluorescently labeled hydrolysis probes &#40;200<span class="elsevierStyleHsp" style=""></span>nM&#41;&#44; from Universal Probe Library &#40;Roche Applied Science&#41;&#46; Gene expression analysis was performed using real-time PCR with final reaction volumes of 10<span class="elsevierStyleHsp" style=""></span>&#956;L &#40;5<span class="elsevierStyleHsp" style=""></span>&#956;L LightCycler<span class="elsevierStyleSup">&#174;</span> 480 Probes Master&#44; 2<span class="elsevierStyleHsp" style=""></span>&#956;L water &#91;PCR Grade&#93;&#44; 0&#46;5<span class="elsevierStyleHsp" style=""></span>&#956;L RealTime ready Assay and 2&#46;5<span class="elsevierStyleHsp" style=""></span>&#956;L cDNA sample&#41;&#46; Thermal cycling on the LightCycler<span class="elsevierStyleSup">&#174;</span> 480 used the following program&#58; one cycle at 95<span class="elsevierStyleHsp" style=""></span>&#176;C for 10<span class="elsevierStyleHsp" style=""></span>min for enzyme activation and denaturation&#44; followed by 45 cycles of 95<span class="elsevierStyleHsp" style=""></span>&#176;C for 10<span class="elsevierStyleHsp" style=""></span>s&#44; 60<span class="elsevierStyleHsp" style=""></span>&#176;C for 30<span class="elsevierStyleHsp" style=""></span>s and signal detection at 72<span class="elsevierStyleHsp" style=""></span>&#176;C for 1<span class="elsevierStyleHsp" style=""></span>s&#44; with detection and cooling at 40<span class="elsevierStyleHsp" style=""></span>&#176;C for 30<span class="elsevierStyleHsp" style=""></span>s&#46; The samples subjected to the 45 cycles were assayed in duplicate&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Gene expression levels were evaluated using the threshold cycle &#40;Ct&#41; method&#46; This data was normalized to the 18 ribosomal RNA reference gene and analyzed according to the 2<span class="elsevierStyleSup">&#8722;&#916;Ct</span> method&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Statistical analysis</span><p id="par0095" class="elsevierStylePara elsevierViewall">Quantitative variables were presented as medians &#40;interquartile range &#91;IQR&#93;&#58; P25-P75&#41;&#44; since they followed a non-normal distribution&#46; We executed the non-parametric Wilcoxon test to analyze within-group differences&#44; and the Mann Whitney <span class="elsevierStyleItalic">U</span> test to verify between-group differences&#46; If significant differences were obtained&#44; 95&#37; confidence intervals &#40;CI&#41; were calculated&#46; Spearman&#39;s rank correlation was used to test the association between biomarkers analyzed in this study&#46; Receiver Operator Characteristic &#40;ROC&#41; curve analysis was performed on U-II serum values and on U-II&#44; URP and UT 2<span class="elsevierStyleSup">&#8722;&#916;Ct</span> values to allocate rats in the Sham or SAH groups&#46; The resulting area under the curve &#40;AUC&#41; was used to establish a cut-off point for animal classification&#44; choosing the point which reached the greatest sum of sensitivity plus specificity&#46; Statistical significance was defined as <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#46; Statistical analyses were performed using SPSS software &#40;Version 20&#46;0&#44; Chicago&#44; IL&#44; USA&#41;&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Results</span><p id="par0100" class="elsevierStylePara elsevierViewall">A total of 96 animals underwent surgery&#46; They were classified as follows&#58; 22 Sham and 74 SAH&#46; Four animals &#40;including one Sham animal&#41; died within 5 days of the surgical intervention&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">The macroscopic evaluation of the brains showed that one SAH rat presented an intercisural hematoma&#46;</p><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Urotensin-II serum levels</span><p id="par0110" class="elsevierStylePara elsevierViewall">When analyzing U-II serum levels&#44; we observed the following results&#58; the SAH rats suffered an increase on U-II serum values from day 1 &#40;0&#46;62<span class="elsevierStyleHsp" style=""></span>pg&#47;mL &#91;IQR 0&#46;36&#8211;1&#46;8&#93;&#41; to day 5 &#40;0&#46;74<span class="elsevierStyleHsp" style=""></span>pg&#47;mL &#91;IQR 0&#46;39&#8211;1&#46;43&#93;&#41; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;04&#41;&#46; In the Sham group&#44; no significant differences in U-II serum levels were found between day 1 &#40;0&#46;56<span class="elsevierStyleHsp" style=""></span>pg&#47;mL &#91;IQR 0&#46;06&#8211;0&#46;83&#93;&#41; and day 5 &#40;0&#46;37<span class="elsevierStyleHsp" style=""></span>pg&#47;mL &#91;IQR 0&#46;23&#8211;0&#46;62&#93;&#41; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;959&#41;&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Between-group differences in U-II serum levels were found on day 5 &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;008&#41; but not on day 1 &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;174&#41;&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Based on U-II serum levels on day 1 in the Sham group&#44; we were able to define the normal median basal serum level for U-II in rats&#58; 0&#46;56<span class="elsevierStyleHsp" style=""></span>pg&#47;mL &#40;IQR 0&#46;06&#8211;0&#46;83&#41;&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">U-II&#44; URP and UT mRNA expression</span><p id="par0125" class="elsevierStylePara elsevierViewall">For conducting PCR&#44; half lymphocyte samples were randomly selected from both animal groups&#46; The remaining samples were stored for possible future analysis&#46; Thus&#44; we selected 37 SAH samples and 11 Sham samples&#46; Three of the SAH group samples did not have sufficient RNA for inclusion in the analysis&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">The results showed that the SAH rats had higher expression levels for URP and UT genes&#58; URP 2<span class="elsevierStyleSup">&#8722;&#916;Ct</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7&#46;07<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">&#8722;6</span> &#40;IQR 7&#46;48<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">&#8722;7</span>&#8211;6&#46;40<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">&#8722;3</span>&#41; SAH vs&#46; URP 2<span class="elsevierStyleSup">&#8722;&#916;Ct</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>8&#46;38<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">&#8722;7</span> &#40;IQR 4&#46;37<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">&#8722;7</span>&#8211;11&#46;58<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">&#8722;7</span>&#41; Sham&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;037&#59; UT 2<span class="elsevierStyleSup">&#8722;&#916;Ct</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;97<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">&#8722;6</span> &#40;IQR 2&#46;26<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">&#8722;7</span>&#8211;4&#46;49<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">&#8722;5</span>&#41; SAH vs&#46; UT 2<span class="elsevierStyleSup">&#8722;&#916;Ct</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;22<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">&#8722;7</span> &#40;IQR 1&#46;37<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">&#8722;7</span>&#8211;4&#46;50<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">&#8722;7</span>&#41; Sham&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;046 &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; U-II expression levels did not reach statistical significance&#58; U-II 2<span class="elsevierStyleSup">&#8722;&#916;Ct</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;28<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">&#8722;7</span> &#40;IQR 2&#46;84<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">&#8722;8</span>&#8211;2&#46;04<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">&#8722;6</span>&#41; SAH vs&#46; U-II 2<span class="elsevierStyleSup">&#8722;&#916;Ct</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#46;02<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">&#8722;8</span> &#40;IQR 2&#46;55<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">&#8722;8</span>&#8211;9&#46;64<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">&#8722;8</span>&#41; Sham&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;175&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0135" class="elsevierStylePara elsevierViewall">In the correlation analysis&#44; in the SAH group&#44; all the quantified gene expressions correlated positively with each other&#58; U-II vs&#46; URP <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;786&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#59; U-II vs&#46; UT <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;727&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#59; URP vs&#46; UT <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;906&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#46; Additionally&#44; URP mRNA showed a positive correlation with U-II serum levels on day 1 &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;490&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;024&#41; and with U-II serum levels on day 5 &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;409&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;038&#41;&#46; In the Sham group&#44; just correlation between U-II 2<span class="elsevierStyleSup">&#8722;&#916;Ct</span> and UT 2<span class="elsevierStyleSup">&#8722;&#916;Ct</span> was found &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;767&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;016&#41;&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0160">Receiver operating characteristics curves</span><p id="par0140" class="elsevierStylePara elsevierViewall">ROC curves were calculated for U-II serum levels and for U-II&#44; URP and UT mRNA expression&#46; The analysis showed that day 5<span class="elsevierStyleHsp" style=""></span>U-II serum levels&#44; URP mRNA and UT mRNA could discriminate between Sham and SAH rats&#46; The AUC for these variables were&#58; AUC<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;691&#59; 95&#37;CI&#58; 0&#46;565&#8211;0&#46;817&#59; for day 5<span class="elsevierStyleHsp" style=""></span>U-II serum levels&#59; AUC<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;706&#59; 95&#37;CI&#58; 0&#46;543&#8211;0&#46;868&#59; for URP&#59; and&#44; AUC<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;713&#59; 95&#37;CI&#58; 0&#46;540&#8211;0&#46;887&#59; for UT &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0145" class="elsevierStylePara elsevierViewall">When examining the coordinates of the ROC curve for day 5 U-II serum levels&#44; we observed that the best cut-off&#44; chosen as the one which reached the greatest sum of sensitivity plus specificity&#44; was the value previously defined as the normal median basal serum level for U-II in rats&#58; 0&#46;56<span class="elsevierStyleHsp" style=""></span>pg&#47;mL&#44; with 66&#46;2&#37; sensitivity and 76&#46;2&#37; specificity&#44; 2&#46;15 positive likelihood ratio &#40;LR&#43;&#41;&#44; 0&#46;42 negative likelihood ratio &#40;LR&#8722;&#41;&#46; In our series&#44; the best cut-offs for gene expression were 2<span class="elsevierStyleSup">&#8722;&#916;Ct</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#46;77<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">&#8722;7</span> for URP&#44; and 2<span class="elsevierStyleSup">&#8722;&#916;Ct</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;62<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">&#8722;6</span> for UT&#46; These cut-offs were applied in our model to determine the accuracy of the variables&#46; URP mRNA displayed 61&#46;3&#37; sensitivity and 83&#46;3&#37; specificity&#44; 3&#46;67 LR&#43;&#44; 0&#46;46 LR&#8722;&#59; and UT mRNA showed 60&#37; sensitivity and 80&#37; specificity&#44; 3 LR&#43;&#44; 0&#46;5 LR&#8722;&#46;</p></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0165">Discussion</span><p id="par0150" class="elsevierStylePara elsevierViewall">This is the first study carried out in an experimental murine model to demonstrate that U-II serum levels are significantly elevated on fifth day after SAH&#44; date that coincides with the usual CVS period in both rats<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">24</span></a> and humans&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">25</span></a> Moreover&#44; we found that the three urotensinergic system genes were up-regulated after in vivo brain exposure to blood injected into the subarachnoid space&#46; We were also able to define the normal range for U-II serum levels in rats&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">The fact that U-II is widely recognized as a peptide with vasoactive properties&#44;<a class="elsevierStyleCrossRefs" href="#bib0310"><span class="elsevierStyleSup">26&#44;27</span></a> yet no research exists on its role in SAH and its complications&#44; led us to investigate urotensinergic genes in this pathology&#46; In doing so&#44; we detected changes not only in U-II serum level&#44; but in the expression of URP and UT genes as well&#46; We also uncovered the ability of these three genes to discriminate SAH rats&#46; Although no research studies have examined the role of the urotensinergic system in SAH&#44; a recent paper suggested its implication in arterial vasospasm development&#44; based on U-II contraction activity in both intact and depolarized arteries&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">20</span></a> In the present study&#44; the fact that rats with SAH suffer a delayed increase in their gene expression and protein production levels compared to baseline and Sham animals&#44; points to urotensinergic activation in SAH&#46; The increase in plasmatic U-II&#44; limited to the SAH group and confined to the usual CVS period in both rats<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">24</span></a> and humans&#44;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">25</span></a> opens the door to a wide range of possibilities for the study of U-II as a biomarker for cerebral arterial vasoconstriction and even the possibility of constituting a new therapeutic target&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">The results concerning the correlation between quantified gene expression levels coincides with Yoshimoto et al&#46;&#44; who pointed out U-II&#39;s function as an autocrine&#47;paracrine&#46;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">28</span></a> Based on our observations&#44; we could highlight this peptide&#39;s autocrine activity &#40;correlation between three gene expressions of the urotensinergic system&#44; within the lymphocyte&#41; and its possible paracrine activity &#40;correlation between lymphocyte gene expression&#44; specifically URP&#44; and protein serum levels&#41;&#46; Nevertheless&#44; we should note that although there are other sources of U-II release throughout the organism&#44; we only measured mRNA production in the lymphocyte&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">U-II has been proposed as a biomarker for various diseases in humans&#44; since its concentration results in a variety of clinical and experimental pathologies&#44; including renal and heart failure&#44; essential and portal hypertension&#44; diabetes&#44; and liver cirrhosis&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">29</span></a> But before using U-II quantification to assess disease onset or progression&#44; we must first establish a normal range for its physiological serum concentration&#46; Several authors have attempted this&#44; and while most agree that U-II serum concentration is found in the picomolar range in species that have been studied&#44; the reports do not agree on the protein&#39;s exact concentration range&#46;<a class="elsevierStyleCrossRefs" href="#bib0330"><span class="elsevierStyleSup">30&#8211;33</span></a> On the other hand&#44; some authors suggest that the physiological concentration of U-II is under detectable limits&#46;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">34</span></a> This lack of consensus stems from the absence of interchangeability between the analytical assays employed for U-II quantification&#46;<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">35</span></a> These methods include radioimmunoassay&#44; radioreceptor assays&#44; enzyme immunoassays and ELISA&#46;<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">36</span></a> The main obstacle is that these methods use antibodies for&#44; but not limited to&#44; U-II &#40;e&#46;g&#46; U-II metabolites&#41;&#46; In nonhuman U-II plasma quantification&#44; there is an additional problem&#58; despite the high conservation of this protein throughout the species&#44; the exact sequence varies between them&#46;<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">36</span></a> As a result&#44; specific antibodies must be designed for each species&#46; In this study&#44; we solved this problem by using specific biochemical reagents for <span class="elsevierStyleItalic">Rattus norvegicus</span>&#44; in both ELISA and PCR execution&#46; As a result&#44; we were able to define the normal range for U-II serum levels in rats measured by fluorescent enzyme immunoassay &#40;EIA&#44; Phoenix Pharmaceuticals&#44; Inc&#46;&#41;&#46; This range of normal values is a significant finding&#44; given that it could serve as a reference for assessing U-II serum levels not only in SAH but in other pathologies as well&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">The major strengths of this study rest in the utilization of specific biochemical reagents for the species analysis&#46; Additionally&#44; we performed a very easy and reproducible murine model&#44; which would allow other researchers to reproduce our experiments and continue with this line of investigation&#46; Finally&#44; this animal model of SAH allowed us to study biomarker variation in vivo&#44; and thereby study the progression of the disease in real time&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">There were some limitations to the present study&#46; The main limitation was the lack of human analysis&#46; We consider that experimental analysis is important prior to human studies&#44; but we recognize that once demonstrated the up-regulation of the urotensinergic system genes in a SAH model&#44; it is necessary to analyze the same biomarkers in SAH human pathology&#46; We analyzed two blood samples&#44; at baseline and on day 5 after surgery&#44; but did not analyze biomarker evolution throughout the development of the disease&#46; By analyzing more blood samples prior to sacrifice&#44; we could define the kinetics of metabolite production&#46; This research could also benefit from the analysis of other tissues&#44; such as brain tissue&#44; which would provide information on tissue status and their potential gene production&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0170">Conclusion</span><p id="par0180" class="elsevierStylePara elsevierViewall">Ours is the first study carried out in an experimental murine model to demonstrate that U-II protein serum levels&#44; as well as U-II&#44; URP and UT mRNA expression levels are up-regulated on the fifth day after a percutaneous SAH&#44; usual CVS period in both rats<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">24</span></a> and humans&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">25</span></a> Furthermore&#44; the three genes showed a high discriminative ability to identify SAH rats&#46; These findings suggest that measurements of gene expression or production&#44; depending on the gene&#44; could serve as biomarkers for SAH onset and progression&#46; Additional studies on SAH patients would be necessary to ascertain the U-II correlation with CVS development&#44; and subsequently determine if this tendency is also observed in humans&#46; These noninvasive analyses could offer physicians early and accurate information on a patient&#39;s condition&#46; Furthermore&#44; these results open a new research line for the design of new therapeutic targets for the treatment of the SAH pathology&#46;</p></span><span id="sec0095" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0175">Funding</span><p id="par0200" class="elsevierStylePara elsevierViewall">This study was funded by a grant from the Instituto de Salud Carlos III &#40;Spanish National Health System&#41; &#40;10&#47;02044&#41;&#44; Consejer&#237;a de Igualdad&#44; Salud y Pol&#237;ticas Sociales de Andaluc&#237;a&#44; Spain &#40;PI-0136-2012&#41; and Consejer&#237;a de Igualdad&#44; Salud y Pol&#237;ticas Sociales de Andaluc&#237;a&#44; Spain &#40;PI-0002-2013&#41;&#46;</p></span><span id="sec0100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0180">Authors contribution</span><p id="par0205" class="elsevierStylePara elsevierViewall">The manuscript has been read and approved by all of the authors and each author believes that the manuscript represents honest work&#46;</p></span><span id="sec0105" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0185">Conflict of interest</span><p id="par0210" class="elsevierStylePara elsevierViewall">The authors declare no conflicting interest in this work&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:15 [
        0 => array:3 [
          "identificador" => "xres932880"
          "titulo" => "Abstract"
          "secciones" => array:8 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Objective"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Design"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Setting"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Participants"
            ]
            4 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Interventions"
            ]
            5 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "Main variables of interest"
            ]
            6 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Results"
            ]
            7 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Conclusion"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec907289"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres932881"
          "titulo" => "Resumen"
          "secciones" => array:8 [
            0 => array:2 [
              "identificador" => "abst0045"
              "titulo" => "Objetivo"
            ]
            1 => array:2 [
              "identificador" => "abst0050"
              "titulo" => "Dise&#241;o"
            ]
            2 => array:2 [
              "identificador" => "abst0055"
              "titulo" => "&#193;mbito"
            ]
            3 => array:2 [
              "identificador" => "abst0060"
              "titulo" => "Participantes"
            ]
            4 => array:2 [
              "identificador" => "abst0065"
              "titulo" => "Intervenciones"
            ]
            5 => array:2 [
              "identificador" => "abst0070"
              "titulo" => "Principales variables de inter&#233;s"
            ]
            6 => array:2 [
              "identificador" => "abst0075"
              "titulo" => "Resultados"
            ]
            7 => array:2 [
              "identificador" => "abst0080"
              "titulo" => "Conclusi&#243;n"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec907288"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Materials and methods"
          "secciones" => array:5 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Animals and samples"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Procedures for the two animal models"
            ]
            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Measurement of Urotensin-II serum levels"
            ]
            3 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "Nucleic acid extraction"
            ]
            4 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "Real-time PCR"
            ]
          ]
        ]
        6 => array:2 [
          "identificador" => "sec0040"
          "titulo" => "Statistical analysis"
        ]
        7 => array:3 [
          "identificador" => "sec0045"
          "titulo" => "Results"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0050"
              "titulo" => "Urotensin-II serum levels"
            ]
            1 => array:2 [
              "identificador" => "sec0055"
              "titulo" => "U-II&#44; URP and UT mRNA expression"
            ]
            2 => array:2 [
              "identificador" => "sec0060"
              "titulo" => "Receiver operating characteristics curves"
            ]
          ]
        ]
        8 => array:2 [
          "identificador" => "sec0065"
          "titulo" => "Discussion"
        ]
        9 => array:2 [
          "identificador" => "sec0070"
          "titulo" => "Conclusion"
        ]
        10 => array:2 [
          "identificador" => "sec0095"
          "titulo" => "Funding"
        ]
        11 => array:2 [
          "identificador" => "sec0100"
          "titulo" => "Authors contribution"
        ]
        12 => array:2 [
          "identificador" => "sec0105"
          "titulo" => "Conflict of interest"
        ]
        13 => array:2 [
          "identificador" => "xack314922"
          "titulo" => "Acknowledgments"
        ]
        14 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2016-06-17"
    "fechaAceptado" => "2016-10-23"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec907289"
          "palabras" => array:5 [
            0 => "Subarachnoid hemorrhage"
            1 => "Experimental model"
            2 => "Biomarkers"
            3 => "Urotensin"
            4 => "Urotensinergic system"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec907288"
          "palabras" => array:5 [
            0 => "Hemorragia subaracnoidea"
            1 => "Modelo experimental"
            2 => "Biomarcadores"
            3 => "Urotensina"
            4 => "Sistema urotensin&#233;rgico"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Cerebral vasospasm&#44; one of the main complications of subarachnoid hemorrhage &#40;SAH&#41;&#44; is characterized by arterial constriction and mainly occurs from day 4 until the second week after the event&#46; Urotensin-II &#40;U-II&#41; has been described as the most potent vasoconstrictor peptide in mammals&#46; An analysis is made of the serum U-II concentrations and mRNA expression levels of U-II&#44; urotensin related peptide &#40;URP&#41; and urotensin receptor &#40;UT&#41; genes in an experimental murine model of SAH&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Design</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">An experimental study was carried out&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Setting</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Experimental operating room of the Biomedicine Institute of Seville &#40;IBiS&#41;&#44; Virgen del Roc&#237;o University Hospital &#40;Seville&#44; Spain&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Participants</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">96 Wistar rats&#58; 74 SAH and 22 sham intervention animals&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Interventions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Day 1&#58; blood sampling&#44; followed by the percutaneous injection of 100<span class="elsevierStyleHsp" style=""></span>&#956;l saline &#40;sham&#41; or blood &#40;SAH&#41; into the subarachnoid space&#46; Day 5&#58; blood sampling&#44; followed by sacrifice of the animals&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Main variables of interest</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Weight&#44; early mortality&#44; serum U-II levels&#44; mRNA values for U-II&#44; URP and UT&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Serum U-II levels increased in the SAH group from day 1 &#40;0&#46;62<span class="elsevierStyleHsp" style=""></span>pg&#47;mL &#91;IQR 0&#46;36&#8211;1&#46;08&#93;&#41; to day 5 &#40;0&#46;74<span class="elsevierStyleHsp" style=""></span>pg&#47;mL &#91;IQR 0&#46;39&#8211;1&#46;43&#93;&#41; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#44; though not in the sham group &#40;0&#46;56<span class="elsevierStyleHsp" style=""></span>pg&#47;mL &#91;IQR 0&#46;06&#8211;0&#46;83&#93; day 1&#59; 0&#46;37<span class="elsevierStyleHsp" style=""></span>pg&#47;mL &#91;IQR 0&#46;23&#8211;0&#46;62&#93; day 5&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;959&#41;&#46; Between-group differences were found on day 5 &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; The ROC analysis showed that the day 5 serum U-II levels &#40;AUC<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;691&#41;&#44; URP mRNA &#40;AUC<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;706&#41; and UT mRNA &#40;AUC<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;713&#41; could discriminate between sham and SAH rats&#46; The normal serum U-II concentration range in rats was 0&#46;56<span class="elsevierStyleHsp" style=""></span>pg&#47;mL &#40;IQR 0&#46;06&#8211;0&#46;83&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Conclusion</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The urotensinergic system is upregulated on day 5 in an experimental model of SAH&#46;</p></span>"
        "secciones" => array:8 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Objective"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Design"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Setting"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Participants"
          ]
          4 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Interventions"
          ]
          5 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Main variables of interest"
          ]
          6 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Results"
          ]
          7 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusion"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Objetivo</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">El vasoespasmo cerebral&#44; una de las principales complicaciones secundarias a hemorragia subaracnoidea &#40;HSA&#41;&#44; se caracteriza por una constricci&#243;n arterial que tiene lugar principalmente entre el d&#237;a 4 y la segunda semana&#46; La urotensina-II &#40;U-II&#41; ha sido definida como el p&#233;ptido con mayor capacidad vasoconstrictora en mam&#237;feros&#46; Quisimos analizar los niveles s&#233;ricos de U-II&#44; as&#237; como los niveles de expresi&#243;n de los genes de U-II&#44; p&#233;ptido relacionado con urotensina y receptor de urotensina&#44; en un modelo murino experimental de HSA&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Dise&#241;o</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Estudio experimental&#46;</p></span> <span id="abst0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">&#193;mbito</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Quir&#243;fano experimental del Instituto de Biomedicina de Sevilla&#44; Hospital Universitario Virgen del Roc&#237;o&#46;</p></span> <span id="abst0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Participantes</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Noventa y seis ratas Wistar&#58; 74 con inyecci&#243;n percut&#225;nea de sangre &#40;HSA&#41;&#44; 22 con inyecci&#243;n percut&#225;nea de 100<span class="elsevierStyleHsp" style=""></span>&#956;L de salino &#40;Sham&#41;&#46;</p></span> <span id="abst0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Intervenciones</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">D&#237;a 1&#58; extracci&#243;n de muestras de sangre&#46; Posteriormente&#44; inyecci&#243;n percut&#225;nea de 100<span class="elsevierStyleHsp" style=""></span>&#956;L de salino &#40;Sham&#41; o de sangre &#40;HSA&#41; en el espacio subaracnoideo&#46; D&#237;a 5&#58; extracci&#243;n de muestras de sangre y sacrificio del animal&#46;</p></span> <span id="abst0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Principales variables de inter&#233;s</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Peso&#44; mortalidad precoz&#44; niveles s&#233;ricos de U-II&#44; valores de ARNm de U-II&#44; p&#233;ptido relacionado con urotensina y receptor de urotensina&#46;</p></span> <span id="abst0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Resultados</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Observamos un incremento en los niveles de U-II s&#233;rica en el grupo HSA desde el d&#237;a 1 &#40;0&#44;62<span class="elsevierStyleHsp" style=""></span>pg&#47;mL &#91;RI 0&#44;36-1&#44;08&#93;&#41; al d&#237;a 5 &#40;0&#44;74<span class="elsevierStyleHsp" style=""></span>pg&#47;mL &#91;RI 0&#44;39-1&#44;43&#93;&#41; &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#59; pero no observamos tal diferencia en el grupo Sham &#40;0&#44;56<span class="elsevierStyleHsp" style=""></span>pg&#47;mL &#91;RI 0&#44;06-0&#44;83&#93; d&#237;a 1&#59; 0&#44;37<span class="elsevierStyleHsp" style=""></span>pg&#47;mL &#91;RI 0&#44;23-0&#44;62&#93; d&#237;a 5&#41; &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;959&#41;&#46; Se encontraron diferencias en los niveles de U-II entre ambos grupos al quinto d&#237;a &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; El an&#225;lisis de curvas ROC demostr&#243; que la U-II s&#233;rica al quinto d&#237;a &#40;AUC<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;691&#41;&#44; ARNm de p&#233;ptido relacionado con urotensina &#40;AUC<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;706&#41; y ARNm de receptor de urotensina &#40;AUC<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;713&#41; pod&#237;an discriminar entre ratas Sham y HSA&#46; Adem&#225;s&#44; definimos un rango de normalidad para los niveles de U-II s&#233;ricos en ratas&#58; 0&#44;56<span class="elsevierStyleHsp" style=""></span>pg&#47;mL &#40;RI 0&#44;06-0&#44;83&#41;&#46;</p></span> <span id="abst0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conclusi&#243;n</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Este estudio demuestra por primera vez que el sistema urotensin&#233;rgico ve incrementada su expresi&#243;n en el quinto d&#237;a en un modelo de HSA&#46;</p></span>"
        "secciones" => array:8 [
          0 => array:2 [
            "identificador" => "abst0045"
            "titulo" => "Objetivo"
          ]
          1 => array:2 [
            "identificador" => "abst0050"
            "titulo" => "Dise&#241;o"
          ]
          2 => array:2 [
            "identificador" => "abst0055"
            "titulo" => "&#193;mbito"
          ]
          3 => array:2 [
            "identificador" => "abst0060"
            "titulo" => "Participantes"
          ]
          4 => array:2 [
            "identificador" => "abst0065"
            "titulo" => "Intervenciones"
          ]
          5 => array:2 [
            "identificador" => "abst0070"
            "titulo" => "Principales variables de inter&#233;s"
          ]
          6 => array:2 [
            "identificador" => "abst0075"
            "titulo" => "Resultados"
          ]
          7 => array:2 [
            "identificador" => "abst0080"
            "titulo" => "Conclusi&#243;n"
          ]
        ]
      ]
    ]
    "multimedia" => array:2 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 650
            "Ancho" => 3332
            "Tamanyo" => 121715
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Expression of U-II &#40;A&#41;&#44; URP &#40;B&#41; and UT &#40;C&#41; by quantitative RT-PCR assay on the fifth day after brain exposure to blood &#40;SAH&#41; compared to saline injection &#40;Sham&#41;&#46; &#40;U-II&#58; <span class="elsevierStyleItalic">p</span> &#61; 0&#46;175&#59; URP&#58; <span class="elsevierStyleItalic">p</span> &#61; 0&#46;037&#59; UT&#58; <span class="elsevierStyleItalic">p</span> &#61; 0&#46;046 relative to Sham&#41;&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1135
            "Ancho" => 3411
            "Tamanyo" => 162574
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">ROC analysis comparing sensitivity to 1-specificity of serum U-II on fifth day &#40;A&#41;&#44; URP mRNA &#40;B&#41; and UT mRNA &#40;C&#41; to discriminate SAH rats&#46; &#40;A&#58; AUC<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;691 &#91;95&#37;CI&#58; 0&#46;565&#8211;0&#46;817&#93;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;008&#59; AUC<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;706 &#91;95&#37;CI&#58; 0&#46;543&#8211;0&#46;868&#93; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;038&#59; C&#58; AUC<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;713 &#91;95&#37;CI&#58; 0&#46;540&#8211;0&#46;887&#93; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;046&#41;&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:36 [
            0 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology and clinical presentation of aneurysmal subarachnoid hemorrhage"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "K&#46;J&#46; Becker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurg Clin N Am"
                        "fecha" => "1998"
                        "volumen" => "9"
                        "paginaInicial" => "435"
                        "paginaFinal" => "444"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9668178"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The EHSA project&#58; the study of spontaneous subarachnoid haemorrhages in Andalusia&#46; Incidence and results"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;A&#46; Munoz-Sanchez"
                            1 => "C&#46; Garcia-Alfaro"
                            2 => "A&#46; Munoz-Lopez"
                            3 => "F&#46; Guerrero-Lopez"
                            4 => "J&#46;M&#46; Jimenez-Moragas"
                            5 => "F&#46; Murillo-Cabezas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Neurol"
                        "fecha" => "2003"
                        "volumen" => "36"
                        "paginaInicial" => "301"
                        "paginaFinal" => "306"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12599122"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The detection and management of unruptured intracranial aneurysms"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;M&#46; Wardlaw"
                            1 => "P&#46;M&#46; White"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Brain"
                        "fecha" => "2000"
                        "volumen" => "123"
                        "paginaInicial" => "205"
                        "paginaFinal" => "221"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10648430"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Subarachnoid haemorrhage&#58; diagnosis&#44; causes and management"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; van Gijn"
                            1 => "G&#46;J&#46; Rinkel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Brain"
                        "fecha" => "2001"
                        "volumen" => "124"
                        "paginaInicial" => "249"
                        "paginaFinal" => "278"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11157554"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical course of spontaneous subarachnoid hemorrhage&#58; a population-based study in King County&#44; Washington"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "W&#46;T&#46; Longstreth Jr&#46;"
                            1 => "L&#46;M&#46; Nelson"
                            2 => "T&#46;D&#46; Koepsell"
                            3 => "G&#46; van Belle"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurology"
                        "fecha" => "1993"
                        "volumen" => "43"
                        "paginaInicial" => "712"
                        "paginaFinal" => "718"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8469328"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology of aneurysmal subarachnoid hemorrhage"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46;E&#46; Zacharia"
                            1 => "Z&#46;L&#46; Hickman"
                            2 => "B&#46;T&#46; Grobelny"
                            3 => "P&#46; DeRosa"
                            4 => "I&#46; Kotchetkov"
                            5 => "A&#46;F&#46; Ducruet"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.nec.2009.10.002"
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurg Clin N Am"
                        "fecha" => "2010"
                        "volumen" => "21"
                        "paginaInicial" => "221"
                        "paginaFinal" => "233"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20380965"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Emergency transcranial doppler ultrasound&#58; predictive value for the development of symptomatic vasospasm in spontaneous subarachnoid hemorrhage in patients in good neurological condition"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;A&#46; Munoz-Sanchez"
                            1 => "F&#46; Murillo-Cabezas"
                            2 => "J&#46;J&#46; Egea-Guerrero"
                            3 => "M&#46;L&#46; Gascon-Castillo"
                            4 => "P&#46; Cancela"
                            5 => "R&#46; Amaya-Villar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.medin.2012.01.013"
                      "Revista" => array:6 [
                        "tituloSerie" => "Med Intensiva"
                        "fecha" => "2012"
                        "volumen" => "36"
                        "paginaInicial" => "611"
                        "paginaFinal" => "618"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22425337"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Endothelin-1 in subarachnoid hemorrhage&#58; an acute-phase reactant produced by cerebrospinal fluid leukocytes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46; Fassbender"
                            1 => "B&#46; Hodapp"
                            2 => "S&#46; Rossol"
                            3 => "T&#46; Bertsch"
                            4 => "J&#46; Schmeck"
                            5 => "S&#46; Schutt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Stroke"
                        "fecha" => "2000"
                        "volumen" => "31"
                        "paginaInicial" => "2971"
                        "paginaFinal" => "2975"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11108758"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mechanism of oxyhemoglobin-induced release of endothelin-1 from cultured vascular endothelial cells and smooth-muscle cells"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "H&#46; Kasuya"
                            1 => "B&#46;K&#46; Weir"
                            2 => "D&#46;M&#46; White"
                            3 => "K&#46; Stefansson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1993.79.6.0892"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1993"
                        "volumen" => "79"
                        "paginaInicial" => "892"
                        "paginaFinal" => "898"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7504096"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Interactive role of protein kinase C-delta with rho-kinase in the development of cerebral vasospasm in a canine two-hemorrhage model"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46; Obara"
                            1 => "S&#46; Nishizawa"
                            2 => "M&#46; Koide"
                            3 => "K&#46; Nozawa"
                            4 => "A&#46; Mitate"
                            5 => "T&#46; Ishikawa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000083093"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Vasc Res"
                        "fecha" => "2005"
                        "volumen" => "42"
                        "paginaInicial" => "67"
                        "paginaFinal" => "76"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15637442"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Alterations in perivascular dilatory neuropeptides &#40;CGRP&#44; SP&#44; VIP&#41; in the external jugular vein and in the cerebrospinal fluid following subarachnoid haemorrhage in man"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Juul"
                            1 => "H&#46; Hara"
                            2 => "S&#46;E&#46; Gisvold"
                            3 => "A&#46;O&#46; Brubakk"
                            4 => "T&#46;A&#46; Fredriksen"
                            5 => "G&#46; Waldemar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta Neurochir &#40;Wien&#41;"
                        "fecha" => "1995"
                        "volumen" => "132"
                        "paginaInicial" => "32"
                        "paginaFinal" => "41"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Human urotensin-II is a potent vasoconstrictor and agonist for the orphan receptor GPR14"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46;S&#46; Ames"
                            1 => "H&#46;M&#46; Sarau"
                            2 => "J&#46;K&#46; Chambers"
                            3 => "R&#46;N&#46; Willette"
                            4 => "N&#46;V&#46; Aiyar"
                            5 => "A&#46;M&#46; Romanic"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/45809"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nature"
                        "fecha" => "1999"
                        "volumen" => "401"
                        "paginaInicial" => "282"
                        "paginaFinal" => "286"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10499587"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Post-translational processing of prepro-urotensin II"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;M&#46; Conlon"
                            1 => "D&#46; Arnold-Reed"
                            2 => "R&#46;J&#46; Balment"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "FEBS Lett"
                        "fecha" => "1990"
                        "volumen" => "266"
                        "paginaInicial" => "37"
                        "paginaFinal" => "40"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2365069"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Characterization of the biologically and antigenically important regions of urotensin II"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "D&#46; McMaster"
                            1 => "Y&#46; Kobayashi"
                            2 => "J&#46; Rivier"
                            3 => "K&#46; Lederis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Proc West Pharmacol Soc"
                        "fecha" => "1986"
                        "volumen" => "29"
                        "paginaInicial" => "205"
                        "paginaFinal" => "208"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3763612"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Identification of urotensin II-related peptide as the urotensin II-immunoreactive molecule in the rat brain"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46; Sugo"
                            1 => "Y&#46; Murakami"
                            2 => "Y&#46; Shimomura"
                            3 => "M&#46; Harada"
                            4 => "M&#46; Abe"
                            5 => "Y&#46; Ishibashi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Biochem Biophys Res Commun"
                        "fecha" => "2003"
                        "volumen" => "310"
                        "paginaInicial" => "860"
                        "paginaFinal" => "868"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14550283"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Orphan-receptor ligand human urotensin II&#58; receptor localization in human tissues and comparison of vasoconstrictor responses with endothelin-1"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;J&#46; Maguire"
                            1 => "R&#46;E&#46; Kuc"
                            2 => "A&#46;P&#46; Davenport"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/sj.bjp.0703601"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Pharmacol"
                        "fecha" => "2000"
                        "volumen" => "131"
                        "paginaInicial" => "441"
                        "paginaFinal" => "446"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11015293"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Congestive heart failure and expression of myocardial urotensin II"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "S&#46;A&#46; Douglas"
                            1 => "L&#46; Tayara"
                            2 => "E&#46;H&#46; Ohlstein"
                            3 => "N&#46; Halawa"
                            4 => "A&#46; Giaid"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(02)08831-1"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2002"
                        "volumen" => "359"
                        "paginaInicial" => "1990"
                        "paginaFinal" => "1997"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12076554"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Localization of urotensin-II immunoreactivity in normal human kidneys and renal carcinoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Shenouda"
                            1 => "S&#46;A&#46; Douglas"
                            2 => "E&#46;H&#46; Ohlstein"
                            3 => "A&#46; Giaid"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1177/002215540205000702"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Histochem Cytochem"
                        "fecha" => "2002"
                        "volumen" => "50"
                        "paginaInicial" => "885"
                        "paginaFinal" => "889"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12070267"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Expression of urotensin II during focal cerebral ischemic in diabetic rats"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46; Tian"
                            1 => "Y&#46; Li"
                            2 => "W&#46; Hua"
                            3 => "Y&#46; Jia"
                            4 => "M&#46; Zhou"
                            5 => "Y&#46; Gu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Can J Neurol Sci"
                        "fecha" => "2014"
                        "volumen" => "41"
                        "paginaInicial" => "498"
                        "paginaFinal" => "503"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24878476"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Contractile responses to rat urotensin II in resting and depolarized basilar arteries"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Porras-Gonzalez"
                            1 => "J&#46; Urena"
                            2 => "J&#46;J&#46; Egea-Guerrero"
                            3 => "E&#46; Gordillo-Escobar"
                            4 => "F&#46; Murillo-Cabezas"
                            5 => "C&#46; Gonzalez-Montelongo Mdel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s13105-013-0293-0"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Physiol Biochem"
                        "fecha" => "2014"
                        "volumen" => "70"
                        "paginaInicial" => "193"
                        "paginaFinal" => "199"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24136621"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Possible cellular mechanism for cerebral vasospasm after experimental subarachnoid hemorrhage in the dog"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "D&#46;R&#46; Harder"
                            1 => "P&#46; Dernbach"
                            2 => "A&#46; Waters"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1172/JCI113146"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Invest"
                        "fecha" => "1987"
                        "volumen" => "80"
                        "paginaInicial" => "875"
                        "paginaFinal" => "880"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2957393"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An experimental model of mass-type brain damage in the rat&#58; expression of brain damage based on neurospecific enolase and protein S100B"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;J&#46; Egea-Guerrero"
                            1 => "F&#46; Murillo-Cabezas"
                            2 => "A&#46; Rodriguez-Rodriguez"
                            3 => "E&#46; Gordillo-Escobar"
                            4 => "J&#46; Revuelto-Rey"
                            5 => "M&#46;A&#46; Munoz-Sanchez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.medin.2013.03.015"
                      "Revista" => array:6 [
                        "tituloSerie" => "Med Intensiva"
                        "fecha" => "2014"
                        "volumen" => "38"
                        "paginaInicial" => "218"
                        "paginaFinal" => "225"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23786666"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0295"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A new percutaneous model of subarachnoid haemorrhage in rats"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46;A&#46; Munoz-Sanchez"
                            1 => "J&#46;J&#46; Egea-Guerrero"
                            2 => "J&#46; Revuelto-Rey"
                            3 => "M&#46; Moreno-Valladares"
                            4 => "F&#46; Murillo-Cabezas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jneumeth.2012.08.010"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosci Methods"
                        "fecha" => "2012"
                        "volumen" => "211"
                        "paginaInicial" => "88"
                        "paginaFinal" => "93"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22921487"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Vascular NAD&#40;P&#41;H oxidase triggers delayed cerebral vasospasm after subarachnoid hemorrhage in rats"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46;E&#46; Kim"
                            1 => "Y&#46;S&#46; Suh"
                            2 => "M&#46;S&#46; Lee"
                            3 => "K&#46;Y&#46; Kim"
                            4 => "J&#46;H&#46; Lee"
                            5 => "H&#46;S&#46; Lee"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Stroke"
                        "fecha" => "2002"
                        "volumen" => "33"
                        "paginaInicial" => "2687"
                        "paginaFinal" => "2691"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12411662"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0305"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Vasospasm versus delayed cerebral ischemia as an outcome event in clinical trials and observational studies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46;D&#46; Vergouwen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s12028-011-9586-8"
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurocrit Care"
                        "fecha" => "2011"
                        "volumen" => "15"
                        "paginaInicial" => "308"
                        "paginaFinal" => "311"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21748502"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0310"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "R361&#8211;6"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Contraction of major artery segments of rat by fish neuropeptide urotensin II"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "H&#46; Itoh"
                            1 => "Y&#46; Itoh"
                            2 => "J&#46; Rivier"
                            3 => "K&#46; Lederis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Am J Physiol"
                        "fecha" => "1987"
                        "volumen" => "252"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3469918"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0315"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cloning of the cDNA encoding the urotensin II precursor in frog and human reveals intense expression of the urotensin II gene in motoneurons of the spinal cord"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Y&#46; Coulouarn"
                            1 => "I&#46; Lihrmann"
                            2 => "S&#46; Jegou"
                            3 => "Y&#46; Anouar"
                            4 => "H&#46; Tostivint"
                            5 => "J&#46;C&#46; Beauvillain"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Proc Natl Acad Sci U S A"
                        "fecha" => "1998"
                        "volumen" => "95"
                        "paginaInicial" => "15803"
                        "paginaFinal" => "15808"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9861051"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0320"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Role of urotensin II in peripheral tissue as an autocrine&#47;paracrine growth factor"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "T&#46; Yoshimoto"
                            1 => "M&#46; Matsushita"
                            2 => "Y&#46; Hirata"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.peptides.2004.03.028"
                      "Revista" => array:6 [
                        "tituloSerie" => "Peptides"
                        "fecha" => "2004"
                        "volumen" => "25"
                        "paginaInicial" => "1775"
                        "paginaFinal" => "1781"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15476945"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0325"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Urotensin II&#58; a cardiovascular and renal update"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46; Zoccali"
                            1 => "F&#46; Mallamaci"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/MNH.0b013e3282f49566"
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Opin Nephrol Hypertens"
                        "fecha" => "2008"
                        "volumen" => "17"
                        "paginaInicial" => "199"
                        "paginaFinal" => "204"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18277155"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0330"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Plasma urotensin II in heart failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46;M&#46; Richards"
                            1 => "M&#46;G&#46; Nicholls"
                            2 => "J&#46;G&#46; Lainchbury"
                            3 => "S&#46; Fisher"
                            4 => "T&#46;G&#46; Yandle"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2002"
                        "volumen" => "360"
                        "paginaInicial" => "545"
                        "paginaFinal" => "546"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12241661"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0335"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cerebrospinal fluid from a dog with neurologic collapse"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46;A&#46; Thompson"
                            1 => "K&#46;E&#46; Russell"
                            2 => "J&#46;M&#46; Levine"
                            3 => "B&#46;R&#46; Weeks"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Vet Clin Pathol"
                        "fecha" => "2003"
                        "volumen" => "32"
                        "paginaInicial" => "143"
                        "paginaFinal" => "146"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12966466"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0340"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Role of urotensin II in patients on dialysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46; Totsune"
                            1 => "K&#46; Takahashi"
                            2 => "Z&#46; Arihara"
                            3 => "M&#46; Sone"
                            4 => "F&#46; Satoh"
                            5 => "S&#46; Ito"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(01)06002-0"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2001"
                        "volumen" => "358"
                        "paginaInicial" => "810"
                        "paginaFinal" => "811"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11564491"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0345"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "High plasma concentrations of human urotensin II do not alter local or systemic hemodynamics in man"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "I&#46;B&#46; Wilkinson"
                            1 => "J&#46;T&#46; Affolter"
                            2 => "S&#46;L&#46; de Haas"
                            3 => "M&#46;P&#46; Pellegrini"
                            4 => "J&#46; Boyd"
                            5 => "M&#46;J&#46; Winter"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Cardiovasc Res"
                        "fecha" => "2002"
                        "volumen" => "53"
                        "paginaInicial" => "341"
                        "paginaFinal" => "347"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11827684"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0350"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Co-expression of urotensin II and its receptor &#40;GPR14&#41; in human cardiovascular and renal tissues"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Matsushita"
                            1 => "M&#46; Shichiri"
                            2 => "T&#46; Imai"
                            3 => "M&#46; Iwashina"
                            4 => "H&#46; Tanaka"
                            5 => "N&#46; Takasu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Hypertens"
                        "fecha" => "2001"
                        "volumen" => "19"
                        "paginaInicial" => "2185"
                        "paginaFinal" => "2190"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11725162"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib0355"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Differential levels of urotensin-II-like activity determined by radio-receptor and radioimmuno-assays"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "N&#46; Aiyar"
                            1 => "B&#46; Guida"
                            2 => "Z&#46; Ao"
                            3 => "J&#46; Disa"
                            4 => "D&#46; Naselsky"
                            5 => "D&#46;J&#46; Behm"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.peptides.2004.05.015"
                      "Revista" => array:6 [
                        "tituloSerie" => "Peptides"
                        "fecha" => "2004"
                        "volumen" => "25"
                        "paginaInicial" => "1339"
                        "paginaFinal" => "1347"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15350702"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib0360"
              "etiqueta" => "36"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Role of urotensin II in health and disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "B&#46; Ross"
                            1 => "K&#46; McKendy"
                            2 => "A&#46; Giaid"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1152/ajpregu.00706.2009"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Physiol Regul Integr Comp Physiol"
                        "fecha" => "2010"
                        "volumen" => "298"
                        "paginaInicial" => "R1156"
                        "paginaFinal" => "R1172"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20421634"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "agradecimientos" => array:1 [
      0 => array:4 [
        "identificador" => "xack314922"
        "titulo" => "Acknowledgments"
        "texto" => "<p id="par0215" class="elsevierStylePara elsevierViewall">This study was funded by a grant from the <span class="elsevierStyleGrantSponsor" id="gs1">Instituto de Salud Carlos III</span> &#40;Spanish National Health System&#41; &#40;10&#47;02044&#41;&#44; <span class="elsevierStyleGrantSponsor" id="gs2">Consejer&#237;a de Igualdad&#44; Salud y Pol&#237;ticas Sociales de Andaluc&#237;a</span>&#44; Spain &#40;PI-0136-2012&#41; and <span class="elsevierStyleGrantSponsor" id="gs3">Consejer&#237;a de Igualdad&#44; Salud y Pol&#237;ticas Sociales de Andaluc&#237;a</span>&#44; Spain &#40;PI-0002-2013&#41;&#46;</p>"
        "vista" => "all"
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/02105691/0000004100000008/v1_201710301105/S0210569116302583/v1_201710301105/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "18737"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Originales"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/02105691/0000004100000008/v1_201710301105/S0210569116302583/v1_201710301105/en/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569116302583?idApp=WMIE"
]
Compartir
Información de la revista
Vol. 41. Núm. 8.
Páginas 468-474 (noviembre 2017)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Visitas
7565
Vol. 41. Núm. 8.
Páginas 468-474 (noviembre 2017)
Original
Acceso a texto completo
Urotensinergic system genes in experimental subarachnoid hemorrhage
El sistema urotensinérgico en un modelo experimental de hemorragia subaracnoidea
Visitas
7565
M.Á. Muñoz-Sáncheza, A. Rodríguez-Rodríguezb,
Autor para correspondencia
, J.J. Egea-Guerrerob, E. Gordillo-Escobarb, Á. Vilches-Arenasc, A. Carrillo-Vicod,e, J.M. Guerrerod,e, F. Murillo-Cabezasb
a Servicio de Urgencias, Hospital Universitario Virgen del Rocío, IBIS/CSIC/Universidad de Sevilla, Spain
b Cuidados Críticos, Hospital Universitario Virgen del Rocío, IBIS/CSIC/Universidad de Sevilla, Spain
c Servicio de Medicina Preventiva y Salud Pública, Hospital Virgen Macarena, Universidad de Sevilla, Spain
d Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Spain
e Departamento de Bioquimica Médica, Biología molecular e Inmunología, Facultad de Medicina, Universidad de Sevilla, Spain
Este artículo ha recibido
Información del artículo
Resumen
Texto completo
Bibliografía
Descargar PDF
Estadísticas
Figuras (2)
Abstract
Objective

Cerebral vasospasm, one of the main complications of subarachnoid hemorrhage (SAH), is characterized by arterial constriction and mainly occurs from day 4 until the second week after the event. Urotensin-II (U-II) has been described as the most potent vasoconstrictor peptide in mammals. An analysis is made of the serum U-II concentrations and mRNA expression levels of U-II, urotensin related peptide (URP) and urotensin receptor (UT) genes in an experimental murine model of SAH.

Design

An experimental study was carried out.

Setting

Experimental operating room of the Biomedicine Institute of Seville (IBiS), Virgen del Rocío University Hospital (Seville, Spain).

Participants

96 Wistar rats: 74 SAH and 22 sham intervention animals.

Interventions

Day 1: blood sampling, followed by the percutaneous injection of 100μl saline (sham) or blood (SAH) into the subarachnoid space. Day 5: blood sampling, followed by sacrifice of the animals.

Main variables of interest

Weight, early mortality, serum U-II levels, mRNA values for U-II, URP and UT.

Results

Serum U-II levels increased in the SAH group from day 1 (0.62pg/mL [IQR 0.36–1.08]) to day 5 (0.74pg/mL [IQR 0.39–1.43]) (p<0.05), though not in the sham group (0.56pg/mL [IQR 0.06–0.83] day 1; 0.37pg/mL [IQR 0.23–0.62] day 5; p=0.959). Between-group differences were found on day 5 (p<0.05). The ROC analysis showed that the day 5 serum U-II levels (AUC=0.691), URP mRNA (AUC=0.706) and UT mRNA (AUC=0.713) could discriminate between sham and SAH rats. The normal serum U-II concentration range in rats was 0.56pg/mL (IQR 0.06–0.83).

Conclusion

The urotensinergic system is upregulated on day 5 in an experimental model of SAH.

Keywords:
Subarachnoid hemorrhage
Experimental model
Biomarkers
Urotensin
Urotensinergic system
Resumen
Objetivo

El vasoespasmo cerebral, una de las principales complicaciones secundarias a hemorragia subaracnoidea (HSA), se caracteriza por una constricción arterial que tiene lugar principalmente entre el día 4 y la segunda semana. La urotensina-II (U-II) ha sido definida como el péptido con mayor capacidad vasoconstrictora en mamíferos. Quisimos analizar los niveles séricos de U-II, así como los niveles de expresión de los genes de U-II, péptido relacionado con urotensina y receptor de urotensina, en un modelo murino experimental de HSA.

Diseño

Estudio experimental.

Ámbito

Quirófano experimental del Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío.

Participantes

Noventa y seis ratas Wistar: 74 con inyección percutánea de sangre (HSA), 22 con inyección percutánea de 100μL de salino (Sham).

Intervenciones

Día 1: extracción de muestras de sangre. Posteriormente, inyección percutánea de 100μL de salino (Sham) o de sangre (HSA) en el espacio subaracnoideo. Día 5: extracción de muestras de sangre y sacrificio del animal.

Principales variables de interés

Peso, mortalidad precoz, niveles séricos de U-II, valores de ARNm de U-II, péptido relacionado con urotensina y receptor de urotensina.

Resultados

Observamos un incremento en los niveles de U-II sérica en el grupo HSA desde el día 1 (0,62pg/mL [RI 0,36-1,08]) al día 5 (0,74pg/mL [RI 0,39-1,43]) (p<0,05); pero no observamos tal diferencia en el grupo Sham (0,56pg/mL [RI 0,06-0,83] día 1; 0,37pg/mL [RI 0,23-0,62] día 5) (p=0,959). Se encontraron diferencias en los niveles de U-II entre ambos grupos al quinto día (p<0,05). El análisis de curvas ROC demostró que la U-II sérica al quinto día (AUC=0,691), ARNm de péptido relacionado con urotensina (AUC=0,706) y ARNm de receptor de urotensina (AUC=0,713) podían discriminar entre ratas Sham y HSA. Además, definimos un rango de normalidad para los niveles de U-II séricos en ratas: 0,56pg/mL (RI 0,06-0,83).

Conclusión

Este estudio demuestra por primera vez que el sistema urotensinérgico ve incrementada su expresión en el quinto día en un modelo de HSA.

Palabras clave:
Hemorragia subaracnoidea
Modelo experimental
Biomarcadores
Urotensina
Sistema urotensinérgico
Texto completo
Introduction

Spontaneous subarachnoid hemorrhage (SAH) has an annual incidence rate of 4–28 cases per 100,000 people.1,2 SAH accounts for about 80% of all nontraumatic extravasated bleeding into the subarachnoid space, 5% of stroke deaths and over a quarter of potential life years lost due to stroke.1,3,4 Approximately 15% of SAH patients die after aneurysmal rupture. Another 25–50% die within a month of the bleeding. Of those who survive, 40% present disabling sequelae.5,6 It is estimated that cerebral vasospasm (CVS) is responsible for neurological deterioration, and even death, in 15–20% of patients with SAH.5,7 CVS is characterized by diffuse and long-lasting arterial constriction. Several vasoconstrictor proteins have been shown to contribute to this narrowing process.8–11 However, Urotensin-II (U-II), defined as the most potent vasoconstrictor peptide in mammals according to Ames et al. research study, is not among these biomarkers.12

U-II is an 11-amino-acid peptide with a cysteine disulfide bond, derived from the polypeptide precursor known as prepro-urotensin-II (preproU-II).13 Proteolytic cleavage of the C-terminal fragment from this precursor is required for biological activity. The result of this proteolysis is an undecapeptide with a cyclic hexapeptide sequence, fundamental for this hormonal action.14 Once the active form of the peptide is generated, U-II mediates its biological action by interacting with a specific plasma membrane G-protein coupled receptor identified as GRP14, or UT.12 This receptor binds different U-II sequences, including the U-II fragment (4–11) and U-II (5–11), as well as the urotensin-related peptide (URP), which derives from a different precursor.15 URP is shorter (octapeptide), but exhibits the cyclic hexapeptide core sequence. U-II expression has been found throughout the heart, kidney, urogenital system and nervous system.16–18 Tian et al. described its expression, as well as UT expression, in the cytoplasm of neurons and in vascular endothelial cells from rats.19 Our research group recently found that high doses of U-II (10μM) in intact rat cerebral arteries evoke arterial contraction. However, in depolarized vascular smooth muscle, lower U-II concentrations (0.1 and 1μM) cause dose-dependent arterial contraction.20 This effect could facilitate arterial CVS in vascular pathophysiological processes such as SAH, where sustained depolarization is present.21

The objective of the present study was to determine the normal range for U-II serum levels and analyze U-II serum and mRNA expression values for the urotensinergic system genes (U-II, URP and UT) in an experimental murine model of SAH; with the purpose of using these molecules as biomarkers of arterial vasoconstriction in SAH.

Materials and methods

Procedures were performed in the experimental operating room of the Biomedicine Institute of Seville (Instituto de Biomedicina de Sevilla [IBiS]/CSIC University of Seville), at the Virgen del Rocío University Hospital, Seville, Spain. This research project was overseen and approved by our hospital's Animal Experimentation Committee. It met all the legal requirements and ethical standards for research established by current legislation (Directive 2010/63/EU).

Animals and samples

Wistar rats weighing 300–350g were used. The procedure was performed on males, to eliminate the cyclic cardioprotective effects of the estrous cycle. After the procedure, the animals were housed in independent cages, in a dry area away from infectious sources and surgical areas, and kept on a 12:12h light/dark cycle. A stable room temperature was set between 23°C and 27°C. Food and water was provided without restrictions, before and after surgery.

Animals were anesthetized by intraperitoneal injection of the following preparation: 50mg ketamine hydrochloride (Ketolar©, Pfizer; 50mg/mL), 2mL Xylazine (Rompun© 2%, Bayer; 20mg/mL) and 1mg atropine (Atropina Bayer©, 1mg/mL). The optimal dose for analgesia and sedation was established at 0.025mL per gram of body weight.20,22 Adequate depth of anesthesia in the spontaneously breathing rats was ensured by the absence of corneal reflex and withdrawal reflex after pressure on the hind legs. Cardiac and respiratory rates were measured during the procedure.

Procedures for the two animal models

SAH group: The SAH model was executed as previously described by our research group.23 The animals were put in prone position with their heads fixed to a stereotaxic frame (Stoelting©). A non-heparinized syringe was used to obtain 100μL of autologous blood from the proximal part of the tail (1mL BD Plastipak©). This was injected into the intracisternal space via cisterna magna, after extraction of the same volume of CSF.

Sham group: Identical procedures were executed with one exception: 100μL of isotonic saline was administered in place of blood after CSF extraction.

On day 5 post-surgery, the animals were sacrificed with a lethal dose of ketamine hydrochloride (0.01mL/kg) (Ketolar©, Pfizer, 50mg/mL) injected into the intraperitoneal cavity.20,22

Blood draws were performed on day 1 prior to the execution of the animal model and on day 5, prior to the sacrifice. Animals were placed in a supine position for blood sample collection. Using binocular lens, an inguinal incision was made, freeing up layers of the abdominal wall, to expose the femoral vein. For serum isolation, 0.8mL of venous blood was collected in a VACUETTE® serum separator tube containing aprotinin (0.6TIU/mL of blood). An additional extraction was performed on day 5, after the lethal injection of ketamine. Each animal's entire blood volume was extracted by cardiac puncture and collected in a VACUTAINER® CPT™ tube (Cell Preparation Tube) (BD, Franklin Lakes, NJ), for mononuclear cell isolation. Brains were removed and examined macroscopically to analyze the presence or absence of pathological findings.

The VACUETTE® tubes were centrifuged at 1600×g for 10min at room temperature. The separated sera were frozen in aliquots at −80°C prior to their analysis. VACUTAINER® CPT™ tubes were centrifuged at 1900×g for 20min at room temperature. Mononuclear cells were collected from the processed CPT by gently inverting the collection tube several times, and drawing off the mononuclear cells containing plasma with a pipette into a tube containing 10mL of saline. Following the manufacturer's instructions, this tube was centrifuged at 300×g for 5min at 4°C. Mononuclear cells were washed twice with saline as described in the previous step and finally pelleted by centrifugation at 16,000×g for 5min at 4°C in a sterile Eppendorf tube.

Measurement of Urotensin-II serum levels

U-II serum levels were measured by fluorescent enzyme immunoassay (EIA) produced by Phoenix Pharmaceuticals, Inc. For peptide extraction, serum samples were previously loaded into a SEP-COLUMN containing 200mg of C18 (Cat. No. RK-SEPCOL-1) following the manufacturer's indications. Data on cross-reactivity was provided by the manufacturer: 100% with rat UT-II and 11% with URP. No cross-reactivity was found with rat endothelin-I, C-type natriuretic peptide-22, calcitonin gene-related peptide, adrenomedullin, atrial natriuretic peptide, bradykinin, angiotensin II or brain natriuretic peptide.

Nucleic acid extraction

The pelleted mononuclear cells were lysed by repetitive pipetting with 750μL of TRIsure™ Isolation Reagent (Bioline). The samples were incubated for 5min at room temperature to ensure the complete dissociation of nucleoprotein complexes. We then added 300μL of chloroform and vigorously shook the Eppendorf for 15s. This step was followed by 2–15min of incubation on ice, and 15min of centrifugation at 12,000×g, to separate the solution into three phases. The upper colorless phase contained the RNA fraction—it was carefully removed and drawn into an Eppendorf containing 500μL of isopropanol. After 5–10min of incubation, samples of this new mixture were incubated for 2h at −20°C and then centrifuged at 12,000×g for 10min at 4°C to form an RNA pellet. This pellet was isolated and washed twice with 1mL of ethanol. Finally, the pellet was resuspended in 30μL of RNAs-free water.

Prior to cDNA synthesis, extracted RNA concentration and purity (OD260/OD280) were quantified by spectrophotometry at 260–280nm (NanoDrop, PeqLab Technology, Erlangen, Germany). An OD260/OD280 ratio between 1.7 and 2.0 indicates reasonable RNA purity. Samples above or below this purity range were discarded.

One μg of RNA from each sample was retrotranscripted into cDNA with the QuantiTect Reverse Transcription Kit (Qiagen), following the manufacturer's protocol. This protocol includes treating the samples with gDNA wipeout buffer, to eliminate genomic DNA contamination.

Real-time PCR

To conduct a polymerase chain reaction (PCR), half of the lymphocyte samples were selected from both animal groups by applying block randomization. This procedure also ensured that the two subgroups were of equal size. The remaining samples were used for other analyses (unpublished).

Commercially available Real-Time ready assays for the target genes (U-II, URP and UT), and the 18 ribosomal RNA housekeeping genes, were obtained lyophilized in 384-well PCR plates, with forward and reverse primers (400nM) and fluorescently labeled hydrolysis probes (200nM), from Universal Probe Library (Roche Applied Science). Gene expression analysis was performed using real-time PCR with final reaction volumes of 10μL (5μL LightCycler® 480 Probes Master, 2μL water [PCR Grade], 0.5μL RealTime ready Assay and 2.5μL cDNA sample). Thermal cycling on the LightCycler® 480 used the following program: one cycle at 95°C for 10min for enzyme activation and denaturation, followed by 45 cycles of 95°C for 10s, 60°C for 30s and signal detection at 72°C for 1s, with detection and cooling at 40°C for 30s. The samples subjected to the 45 cycles were assayed in duplicate.

Gene expression levels were evaluated using the threshold cycle (Ct) method. This data was normalized to the 18 ribosomal RNA reference gene and analyzed according to the 2−ΔCt method.

Statistical analysis

Quantitative variables were presented as medians (interquartile range [IQR]: P25-P75), since they followed a non-normal distribution. We executed the non-parametric Wilcoxon test to analyze within-group differences, and the Mann Whitney U test to verify between-group differences. If significant differences were obtained, 95% confidence intervals (CI) were calculated. Spearman's rank correlation was used to test the association between biomarkers analyzed in this study. Receiver Operator Characteristic (ROC) curve analysis was performed on U-II serum values and on U-II, URP and UT 2−ΔCt values to allocate rats in the Sham or SAH groups. The resulting area under the curve (AUC) was used to establish a cut-off point for animal classification, choosing the point which reached the greatest sum of sensitivity plus specificity. Statistical significance was defined as p<0.05. Statistical analyses were performed using SPSS software (Version 20.0, Chicago, IL, USA).

Results

A total of 96 animals underwent surgery. They were classified as follows: 22 Sham and 74 SAH. Four animals (including one Sham animal) died within 5 days of the surgical intervention.

The macroscopic evaluation of the brains showed that one SAH rat presented an intercisural hematoma.

Urotensin-II serum levels

When analyzing U-II serum levels, we observed the following results: the SAH rats suffered an increase on U-II serum values from day 1 (0.62pg/mL [IQR 0.36–1.8]) to day 5 (0.74pg/mL [IQR 0.39–1.43]) (p=0.04). In the Sham group, no significant differences in U-II serum levels were found between day 1 (0.56pg/mL [IQR 0.06–0.83]) and day 5 (0.37pg/mL [IQR 0.23–0.62]) (p=0.959).

Between-group differences in U-II serum levels were found on day 5 (p=0.008) but not on day 1 (p=0.174).

Based on U-II serum levels on day 1 in the Sham group, we were able to define the normal median basal serum level for U-II in rats: 0.56pg/mL (IQR 0.06–0.83).

U-II, URP and UT mRNA expression

For conducting PCR, half lymphocyte samples were randomly selected from both animal groups. The remaining samples were stored for possible future analysis. Thus, we selected 37 SAH samples and 11 Sham samples. Three of the SAH group samples did not have sufficient RNA for inclusion in the analysis.

The results showed that the SAH rats had higher expression levels for URP and UT genes: URP 2−ΔCt=7.07×10−6 (IQR 7.48×10−7–6.40×10−3) SAH vs. URP 2−ΔCt=8.38×10−7 (IQR 4.37×10−7–11.58×10−7) Sham, p=0.037; UT 2−ΔCt=1.97×10−6 (IQR 2.26×10−7–4.49×10−5) SAH vs. UT 2−ΔCt=2.22×10−7 (IQR 1.37×10−7–4.50×10−7) Sham, p=0.046 (Fig. 1). U-II expression levels did not reach statistical significance: U-II 2−ΔCt=1.28×10−7 (IQR 2.84×10−8–2.04×10−6) SAH vs. U-II 2−ΔCt=4.02×10−8 (IQR 2.55×10−8–9.64×10−8) Sham, p=0.175.

Figure 1.

Expression of U-II (A), URP (B) and UT (C) by quantitative RT-PCR assay on the fifth day after brain exposure to blood (SAH) compared to saline injection (Sham). (U-II: p = 0.175; URP: p = 0.037; UT: p = 0.046 relative to Sham).

(0.12MB).

In the correlation analysis, in the SAH group, all the quantified gene expressions correlated positively with each other: U-II vs. URP r=0.786, p<0.001; U-II vs. UT r=0.727, p<0.001; URP vs. UT r=0.906, p<0.001. Additionally, URP mRNA showed a positive correlation with U-II serum levels on day 1 (r=0.490; p=0.024) and with U-II serum levels on day 5 (r=0.409; p=0.038). In the Sham group, just correlation between U-II 2−ΔCt and UT 2−ΔCt was found (r=0.767; p=0.016).

Receiver operating characteristics curves

ROC curves were calculated for U-II serum levels and for U-II, URP and UT mRNA expression. The analysis showed that day 5U-II serum levels, URP mRNA and UT mRNA could discriminate between Sham and SAH rats. The AUC for these variables were: AUC=0.691; 95%CI: 0.565–0.817; for day 5U-II serum levels; AUC=0.706; 95%CI: 0.543–0.868; for URP; and, AUC=0.713; 95%CI: 0.540–0.887; for UT (Fig. 2).

Figure 2.

ROC analysis comparing sensitivity to 1-specificity of serum U-II on fifth day (A), URP mRNA (B) and UT mRNA (C) to discriminate SAH rats. (A: AUC=0.691 [95%CI: 0.565–0.817], p=0.008; AUC=0.706 [95%CI: 0.543–0.868] p=0.038; C: AUC=0.713 [95%CI: 0.540–0.887] p=0.046).

(0.16MB).

When examining the coordinates of the ROC curve for day 5 U-II serum levels, we observed that the best cut-off, chosen as the one which reached the greatest sum of sensitivity plus specificity, was the value previously defined as the normal median basal serum level for U-II in rats: 0.56pg/mL, with 66.2% sensitivity and 76.2% specificity, 2.15 positive likelihood ratio (LR+), 0.42 negative likelihood ratio (LR−). In our series, the best cut-offs for gene expression were 2−ΔCt=3.77×10−7 for URP, and 2−ΔCt=1.62×10−6 for UT. These cut-offs were applied in our model to determine the accuracy of the variables. URP mRNA displayed 61.3% sensitivity and 83.3% specificity, 3.67 LR+, 0.46 LR−; and UT mRNA showed 60% sensitivity and 80% specificity, 3 LR+, 0.5 LR−.

Discussion

This is the first study carried out in an experimental murine model to demonstrate that U-II serum levels are significantly elevated on fifth day after SAH, date that coincides with the usual CVS period in both rats24 and humans.25 Moreover, we found that the three urotensinergic system genes were up-regulated after in vivo brain exposure to blood injected into the subarachnoid space. We were also able to define the normal range for U-II serum levels in rats.

The fact that U-II is widely recognized as a peptide with vasoactive properties,26,27 yet no research exists on its role in SAH and its complications, led us to investigate urotensinergic genes in this pathology. In doing so, we detected changes not only in U-II serum level, but in the expression of URP and UT genes as well. We also uncovered the ability of these three genes to discriminate SAH rats. Although no research studies have examined the role of the urotensinergic system in SAH, a recent paper suggested its implication in arterial vasospasm development, based on U-II contraction activity in both intact and depolarized arteries.20 In the present study, the fact that rats with SAH suffer a delayed increase in their gene expression and protein production levels compared to baseline and Sham animals, points to urotensinergic activation in SAH. The increase in plasmatic U-II, limited to the SAH group and confined to the usual CVS period in both rats24 and humans,25 opens the door to a wide range of possibilities for the study of U-II as a biomarker for cerebral arterial vasoconstriction and even the possibility of constituting a new therapeutic target.

The results concerning the correlation between quantified gene expression levels coincides with Yoshimoto et al., who pointed out U-II's function as an autocrine/paracrine.28 Based on our observations, we could highlight this peptide's autocrine activity (correlation between three gene expressions of the urotensinergic system, within the lymphocyte) and its possible paracrine activity (correlation between lymphocyte gene expression, specifically URP, and protein serum levels). Nevertheless, we should note that although there are other sources of U-II release throughout the organism, we only measured mRNA production in the lymphocyte.

U-II has been proposed as a biomarker for various diseases in humans, since its concentration results in a variety of clinical and experimental pathologies, including renal and heart failure, essential and portal hypertension, diabetes, and liver cirrhosis.29 But before using U-II quantification to assess disease onset or progression, we must first establish a normal range for its physiological serum concentration. Several authors have attempted this, and while most agree that U-II serum concentration is found in the picomolar range in species that have been studied, the reports do not agree on the protein's exact concentration range.30–33 On the other hand, some authors suggest that the physiological concentration of U-II is under detectable limits.34 This lack of consensus stems from the absence of interchangeability between the analytical assays employed for U-II quantification.35 These methods include radioimmunoassay, radioreceptor assays, enzyme immunoassays and ELISA.36 The main obstacle is that these methods use antibodies for, but not limited to, U-II (e.g. U-II metabolites). In nonhuman U-II plasma quantification, there is an additional problem: despite the high conservation of this protein throughout the species, the exact sequence varies between them.36 As a result, specific antibodies must be designed for each species. In this study, we solved this problem by using specific biochemical reagents for Rattus norvegicus, in both ELISA and PCR execution. As a result, we were able to define the normal range for U-II serum levels in rats measured by fluorescent enzyme immunoassay (EIA, Phoenix Pharmaceuticals, Inc.). This range of normal values is a significant finding, given that it could serve as a reference for assessing U-II serum levels not only in SAH but in other pathologies as well.

The major strengths of this study rest in the utilization of specific biochemical reagents for the species analysis. Additionally, we performed a very easy and reproducible murine model, which would allow other researchers to reproduce our experiments and continue with this line of investigation. Finally, this animal model of SAH allowed us to study biomarker variation in vivo, and thereby study the progression of the disease in real time.

There were some limitations to the present study. The main limitation was the lack of human analysis. We consider that experimental analysis is important prior to human studies, but we recognize that once demonstrated the up-regulation of the urotensinergic system genes in a SAH model, it is necessary to analyze the same biomarkers in SAH human pathology. We analyzed two blood samples, at baseline and on day 5 after surgery, but did not analyze biomarker evolution throughout the development of the disease. By analyzing more blood samples prior to sacrifice, we could define the kinetics of metabolite production. This research could also benefit from the analysis of other tissues, such as brain tissue, which would provide information on tissue status and their potential gene production.

Conclusion

Ours is the first study carried out in an experimental murine model to demonstrate that U-II protein serum levels, as well as U-II, URP and UT mRNA expression levels are up-regulated on the fifth day after a percutaneous SAH, usual CVS period in both rats24 and humans.25 Furthermore, the three genes showed a high discriminative ability to identify SAH rats. These findings suggest that measurements of gene expression or production, depending on the gene, could serve as biomarkers for SAH onset and progression. Additional studies on SAH patients would be necessary to ascertain the U-II correlation with CVS development, and subsequently determine if this tendency is also observed in humans. These noninvasive analyses could offer physicians early and accurate information on a patient's condition. Furthermore, these results open a new research line for the design of new therapeutic targets for the treatment of the SAH pathology.

Funding

This study was funded by a grant from the Instituto de Salud Carlos III (Spanish National Health System) (10/02044), Consejería de Igualdad, Salud y Políticas Sociales de Andalucía, Spain (PI-0136-2012) and Consejería de Igualdad, Salud y Políticas Sociales de Andalucía, Spain (PI-0002-2013).

Authors contribution

The manuscript has been read and approved by all of the authors and each author believes that the manuscript represents honest work.

Conflict of interest

The authors declare no conflicting interest in this work.

Acknowledgments

This study was funded by a grant from the Instituto de Salud Carlos III (Spanish National Health System) (10/02044), Consejería de Igualdad, Salud y Políticas Sociales de Andalucía, Spain (PI-0136-2012) and Consejería de Igualdad, Salud y Políticas Sociales de Andalucía, Spain (PI-0002-2013).

References
[1]
K.J. Becker.
Epidemiology and clinical presentation of aneurysmal subarachnoid hemorrhage.
Neurosurg Clin N Am, 9 (1998), pp. 435-444
[2]
M.A. Munoz-Sanchez, C. Garcia-Alfaro, A. Munoz-Lopez, F. Guerrero-Lopez, J.M. Jimenez-Moragas, F. Murillo-Cabezas, et al.
The EHSA project: the study of spontaneous subarachnoid haemorrhages in Andalusia. Incidence and results.
Rev Neurol, 36 (2003), pp. 301-306
[3]
J.M. Wardlaw, P.M. White.
The detection and management of unruptured intracranial aneurysms.
Brain, 123 (2000), pp. 205-221
[4]
J. van Gijn, G.J. Rinkel.
Subarachnoid haemorrhage: diagnosis, causes and management.
Brain, 124 (2001), pp. 249-278
[5]
W.T. Longstreth Jr., L.M. Nelson, T.D. Koepsell, G. van Belle.
Clinical course of spontaneous subarachnoid hemorrhage: a population-based study in King County, Washington.
Neurology, 43 (1993), pp. 712-718
[6]
B.E. Zacharia, Z.L. Hickman, B.T. Grobelny, P. DeRosa, I. Kotchetkov, A.F. Ducruet, et al.
Epidemiology of aneurysmal subarachnoid hemorrhage.
Neurosurg Clin N Am, 21 (2010), pp. 221-233
[7]
M.A. Munoz-Sanchez, F. Murillo-Cabezas, J.J. Egea-Guerrero, M.L. Gascon-Castillo, P. Cancela, R. Amaya-Villar, et al.
Emergency transcranial doppler ultrasound: predictive value for the development of symptomatic vasospasm in spontaneous subarachnoid hemorrhage in patients in good neurological condition.
Med Intensiva, 36 (2012), pp. 611-618
[8]
K. Fassbender, B. Hodapp, S. Rossol, T. Bertsch, J. Schmeck, S. Schutt, et al.
Endothelin-1 in subarachnoid hemorrhage: an acute-phase reactant produced by cerebrospinal fluid leukocytes.
Stroke, 31 (2000), pp. 2971-2975
[9]
H. Kasuya, B.K. Weir, D.M. White, K. Stefansson.
Mechanism of oxyhemoglobin-induced release of endothelin-1 from cultured vascular endothelial cells and smooth-muscle cells.
J Neurosurg, 79 (1993), pp. 892-898
[10]
K. Obara, S. Nishizawa, M. Koide, K. Nozawa, A. Mitate, T. Ishikawa, et al.
Interactive role of protein kinase C-delta with rho-kinase in the development of cerebral vasospasm in a canine two-hemorrhage model.
J Vasc Res, 42 (2005), pp. 67-76
[11]
R. Juul, H. Hara, S.E. Gisvold, A.O. Brubakk, T.A. Fredriksen, G. Waldemar, et al.
Alterations in perivascular dilatory neuropeptides (CGRP, SP, VIP) in the external jugular vein and in the cerebrospinal fluid following subarachnoid haemorrhage in man.
Acta Neurochir (Wien), 132 (1995), pp. 32-41
[12]
R.S. Ames, H.M. Sarau, J.K. Chambers, R.N. Willette, N.V. Aiyar, A.M. Romanic, et al.
Human urotensin-II is a potent vasoconstrictor and agonist for the orphan receptor GPR14.
Nature, 401 (1999), pp. 282-286
[13]
J.M. Conlon, D. Arnold-Reed, R.J. Balment.
Post-translational processing of prepro-urotensin II.
FEBS Lett, 266 (1990), pp. 37-40
[14]
D. McMaster, Y. Kobayashi, J. Rivier, K. Lederis.
Characterization of the biologically and antigenically important regions of urotensin II.
Proc West Pharmacol Soc, 29 (1986), pp. 205-208
[15]
T. Sugo, Y. Murakami, Y. Shimomura, M. Harada, M. Abe, Y. Ishibashi, et al.
Identification of urotensin II-related peptide as the urotensin II-immunoreactive molecule in the rat brain.
Biochem Biophys Res Commun, 310 (2003), pp. 860-868
[16]
J.J. Maguire, R.E. Kuc, A.P. Davenport.
Orphan-receptor ligand human urotensin II: receptor localization in human tissues and comparison of vasoconstrictor responses with endothelin-1.
Br J Pharmacol, 131 (2000), pp. 441-446
[17]
S.A. Douglas, L. Tayara, E.H. Ohlstein, N. Halawa, A. Giaid.
Congestive heart failure and expression of myocardial urotensin II.
Lancet, 359 (2002), pp. 1990-1997
[18]
A. Shenouda, S.A. Douglas, E.H. Ohlstein, A. Giaid.
Localization of urotensin-II immunoreactivity in normal human kidneys and renal carcinoma.
J Histochem Cytochem, 50 (2002), pp. 885-889
[19]
L. Tian, Y. Li, W. Hua, Y. Jia, M. Zhou, Y. Gu, et al.
Expression of urotensin II during focal cerebral ischemic in diabetic rats.
Can J Neurol Sci, 41 (2014), pp. 498-503
[20]
C. Porras-Gonzalez, J. Urena, J.J. Egea-Guerrero, E. Gordillo-Escobar, F. Murillo-Cabezas, C. Gonzalez-Montelongo Mdel, et al.
Contractile responses to rat urotensin II in resting and depolarized basilar arteries.
J Physiol Biochem, 70 (2014), pp. 193-199
[21]
D.R. Harder, P. Dernbach, A. Waters.
Possible cellular mechanism for cerebral vasospasm after experimental subarachnoid hemorrhage in the dog.
J Clin Invest, 80 (1987), pp. 875-880
[22]
J.J. Egea-Guerrero, F. Murillo-Cabezas, A. Rodriguez-Rodriguez, E. Gordillo-Escobar, J. Revuelto-Rey, M.A. Munoz-Sanchez, et al.
An experimental model of mass-type brain damage in the rat: expression of brain damage based on neurospecific enolase and protein S100B.
Med Intensiva, 38 (2014), pp. 218-225
[23]
M.A. Munoz-Sanchez, J.J. Egea-Guerrero, J. Revuelto-Rey, M. Moreno-Valladares, F. Murillo-Cabezas.
A new percutaneous model of subarachnoid haemorrhage in rats.
J Neurosci Methods, 211 (2012), pp. 88-93
[24]
D.E. Kim, Y.S. Suh, M.S. Lee, K.Y. Kim, J.H. Lee, H.S. Lee, et al.
Vascular NAD(P)H oxidase triggers delayed cerebral vasospasm after subarachnoid hemorrhage in rats.
Stroke, 33 (2002), pp. 2687-2691
[25]
M.D. Vergouwen.
Vasospasm versus delayed cerebral ischemia as an outcome event in clinical trials and observational studies.
Neurocrit Care, 15 (2011), pp. 308-311
[26]
H. Itoh, Y. Itoh, J. Rivier, K. Lederis.
Contraction of major artery segments of rat by fish neuropeptide urotensin II.
Am J Physiol, 252 (1987),
R361–6
[27]
Y. Coulouarn, I. Lihrmann, S. Jegou, Y. Anouar, H. Tostivint, J.C. Beauvillain, et al.
Cloning of the cDNA encoding the urotensin II precursor in frog and human reveals intense expression of the urotensin II gene in motoneurons of the spinal cord.
Proc Natl Acad Sci U S A, 95 (1998), pp. 15803-15808
[28]
T. Yoshimoto, M. Matsushita, Y. Hirata.
Role of urotensin II in peripheral tissue as an autocrine/paracrine growth factor.
Peptides, 25 (2004), pp. 1775-1781
[29]
C. Zoccali, F. Mallamaci.
Urotensin II: a cardiovascular and renal update.
Curr Opin Nephrol Hypertens, 17 (2008), pp. 199-204
[30]
A.M. Richards, M.G. Nicholls, J.G. Lainchbury, S. Fisher, T.G. Yandle.
Plasma urotensin II in heart failure.
Lancet, 360 (2002), pp. 545-546
[31]
C.A. Thompson, K.E. Russell, J.M. Levine, B.R. Weeks.
Cerebrospinal fluid from a dog with neurologic collapse.
Vet Clin Pathol, 32 (2003), pp. 143-146
[32]
K. Totsune, K. Takahashi, Z. Arihara, M. Sone, F. Satoh, S. Ito, et al.
Role of urotensin II in patients on dialysis.
[33]
I.B. Wilkinson, J.T. Affolter, S.L. de Haas, M.P. Pellegrini, J. Boyd, M.J. Winter, et al.
High plasma concentrations of human urotensin II do not alter local or systemic hemodynamics in man.
Cardiovasc Res, 53 (2002), pp. 341-347
[34]
M. Matsushita, M. Shichiri, T. Imai, M. Iwashina, H. Tanaka, N. Takasu, et al.
Co-expression of urotensin II and its receptor (GPR14) in human cardiovascular and renal tissues.
J Hypertens, 19 (2001), pp. 2185-2190
[35]
N. Aiyar, B. Guida, Z. Ao, J. Disa, D. Naselsky, D.J. Behm, et al.
Differential levels of urotensin-II-like activity determined by radio-receptor and radioimmuno-assays.
Peptides, 25 (2004), pp. 1339-1347
[36]
B. Ross, K. McKendy, A. Giaid.
Role of urotensin II in health and disease.
Am J Physiol Regul Integr Comp Physiol, 298 (2010), pp. R1156-R1172
Copyright © 2016. Elsevier España, S.L.U. y SEMICYUC
Descargar PDF
Idiomas
Medicina Intensiva
Opciones de artículo
Herramientas