Objective:

To explore biomarkers for predicting hematoma expansion (HE) after intracerebral hemorrhage (ICH) using proteomics.

Background:

HE is a common pathological process after ICH, closely associated with poor prognosis. Early and effective prediction of HE is crucial for timely intervention to control its growth and improve outcomes. Plasma proteomics is a reliable and powerful method for screening biomarkers.

Design/Methods:

Clinical data were prospectively collected from patients with acute ICH admitted to the Department of Neurology in our hospital within 6 hours of symptom onset between December 2020 and November 2021. TMT proteomics technology was used to identify differentially expressed proteins in plasma between the HE patients and the non-HE patients. Bioinformatic analysis of the differentially expressed proteins was conducted using the GO and KEGG databases. Based on the mechanisms of HE and a comprehensive literature review, candidate biomarker proteins were selected. These biomarkers were validated in the overall cohort, and their correlation with the volume of HE was examined. The area under the ROC curve (AUC) was calculated to evaluate their predictive ability for HE.

Results:

Among 53 patients with ICH, 25 (47.2%) experienced HE. Among 297 differentially expressed proteins, 9 proteins were selected and verified. Complement C3 levels were significantly elevated in the HE patients, with statistical significance. Correlation analysis showed that complement C3 levels were positively correlated with the absolute volume of HE. ROC curve analysis indicated that complement C3 had good predictive power for HE. In multivariate analysis, after adjusting for factors such as gender, age, and the time between symptom onset and the first CT scan, complement C3 remained associated with HE.

Conclusions:

Complement C3 is a feasible biomarker for predicting HE. It holds potential for guiding the development of new therapeutic targets.