Our results suggest the involvement of TNF-alpha in mechanisms of early stroke-induced inflammation and a predictive value of the initial TNF-alpha levels for the outcome of stroke.

Background and Purpose-Animal models of stroke have shown that focal cerebral ischemia results in an increased expression of several cytokines and chemokines that precedes leukocyte infiltration into ischemic lesions. The infiltrated leukocytes are thought to contribute to tissue injury in stroke. Monocyte chemoattractant protein-1 (MCP-1) may play an important role in monocyte/macrophage infiltration in stroke patients. Methods-We studied MCP-1 level in sera and the cerebrospinal fluid of 23 ischemic stroke patients 24 hours after the onset of neurological symptoms and compared the results with 15 control patients with tension headache. The MCP-1 level was determined by ELISA. Results-There was a significant increase of cerebrospinal fluid MCP-1 level in the studied stroke patients in comparison with the control group. The serum level of MCP-1 did not differ from that of control patients. Conclusions-Our

As proinflammatory cytokines released during ischaemia are detrimental to the brain, the study aimed to evaluate serum interleukin-18 (IL-18) levels in stroke patients and to investigate the relation between these and epidemiological and clinical data. The study comprised 23 ischaemic stroke patients and 15 controls. Blood sampling for IL-18 determination and for chemistry, and brain CT were performed within 24 h of stroke, while neurological stroke severity and functional disability were estimated, respectively, with the Scandinavian stroke scale (SSS) and Barthel index (BI) within the same interval and two weeks later. There were higher serum IL-18 levels in stroke patients. These correlated with erythrocyte sedimentation rate (ESR), brain CT hypodense area volumes, and SSS and BI scores calculated at both studied times. Moreover, IL-18 levels were higher in patients with non-lacunar stroke subtype than in those with lacunar strokes. The results suggest that IL-18 is involved in stroke-induced inflammation and that initial serum IL-18 levels may be predictive of stroke outcome.

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Our results indirectly suggest that PECAM-1 may play a role in the pathophysiological events during early phase of ischaemic stroke.