Circulating lipocalin‐2 as a novel biomarker for early neurological deterioration and unfavorable prognosis after acute ischemic stroke

Xie, Yi; Zhuo, Xingfeng; Xing, Kai; Huang, Zhongcheng; Guo, Hua; Gong, Pei; Zhang, Xiaohao; Li, Yun

doi:10.1002/brb3.2979

Cited by 6 publications

(3 citation statements)

References 49 publications

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“…These results broadly agree with the findings of previous studies. 23,27 A significant association was found between Large-artery atherosclerosis and WMLs burden, which is not supported by some other studies. 21,28 This discrepancy is partly due to the differences in the study population and methods of assessing WMLs.…”

Section: Discussioncontrasting

confidence: 76%

“…The total Fazekas score was calculated by adding the score of periventricular white matter lesions (PWMLs) and deep white matter lesions (DWMLs), which range from 0 to 6. According to previous studies, 21,23,24 all subjects were dichotomized into none-mild WMLs (Fazekas score 0-2) and moderate-severe WMLs (Fazekas score 3-6) according to the total Fazekas score. Furthermore, we categorized the severity of PWMLs and DWMLs as none-mild (Fazekas score 0-1) or moderate-severe (Fazekas score 2-3).…”

Section: Imaging Assessmentmentioning

confidence: 99%

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Higher High-Mobility Group Box-1 Levels are Associated with White Matter Lesions in Ischemic Stroke Patients

Zhao,

Xu,

et al. 2023

JIR

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High-mobility group box-1 (HMGB1) is a useful biomarker for disease severity stratification and prognosis prediction. We aim to explore whether the circulating HMGB1 concentrations are associated with the white matter lesions (WMLs) burden in stroke patients. Methods: Between 2022 June and December 2022, patients with acute ischemic stroke were prospectively enrolled. HMGB1 levels were measured by an enzyme-linked immunosorbent assay after admission for all patients. The WMLs severity was assessed by the Fazekas scale. We dichotomized patients into those with moderate-severe WMLs (Fazekas score 3-6) versus those with none-mild WMLs (Fazekas score 0-2). Furthermore, based on the severity of periventricular WMLs (PWMLs) and deep WMLs (DWMLs), patients were categorized as none-mild (Fazekas score 0-1) or moderate-severe (Fazekas score 2-3). Results: A total of 287 participants (mean age: 64.9 years; 157 male) were analyzed. The median serum HMGB1 levels were 7.3 ng/mL (interquartile, 4.3 ng/mL-12.3 ng/mL). After adjustment for potential confounders, elevated HMGB1 levels were associated with the presence of moderate-severe WMLs (first quartile vs fourth quartile, odds ratio [OR], 4.101; 95% confidence interval [CI], 1.948-8.633; P = 0.001) and moderate-severe PWMLs (first quartile vs fourth quartile, OR, 9.181; 95% CI, 4.078-20.671; P = 0.001). Similar results were found when the HMGB1 levels were analyzed as a continuous variable. Conclusion:This study demonstrated that increased HMGB1 levels were associated with the severity of WMLs, mainly in the periventricular region.

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Section: Discussioncontrasting

confidence: 76%

Section: Imaging Assessmentmentioning

confidence: 99%

Higher High-Mobility Group Box-1 Levels are Associated with White Matter Lesions in Ischemic Stroke Patients

Zhao,

Xu,

et al. 2023

JIR

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“…A total Fazekas score, ranging from 0 to 6, was calculated by summing the periventricular and subcortical WMLs scores [24]. According to previous studies, severe WMLs were defined as a total Fazekas score ≥ 3 [25][26][27].…”

Section: Image Acquisition and Analysismentioning

confidence: 99%

Association between Citrullinated Histone H3 and White Matter Lesions Burden in Patients with Ischemic Stroke

Zhang

Huang

et al. 2023

Brain Sciences

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Introduction: Neutrophil extracellular traps play a role in the pathophysiology of stroke and are associated with severity and mortality. We aimed to investigate whether the citrullinated histone H3 (CitH3), a biomarker for neutrophil extracellular traps formation, is associated with the white matter lesion (WML) burden in ischemic stroke patients. Methods: Between September 2021 and April 2022, 322 patients were enrolled in this prospective observational cohort study. Serum CitH3 levels were measured after admission using an enzyme-linked immunosorbent assay. WMLs severity was graded according to the Fazekas scale and conceptually defined as mild (total Fazekas score 0–2) and severe (total Fazekas score 3–6). We used multivariable regression models to determine the relationship between CitH3 concentrations and the severity of WMLs burden. Results: One-hundred and forty-eight (46.0%) patients were diagnosed with severe WMLs burden after admission. Increased CitH3 levels (first quartile vs. fourth quartile of H3Cit, odds ratio, 3.311, 95% confidence interval, 1.336–8.027; p = 0.011) were independently associated with a greater WML burden in the fully adjusted multivariable model. Similar results were found when the H3Cit was analyzed as a continuous variable. Furthermore, the multiple-adjusted spline regression model showed a linear association between H3Cit levels and severe WMLs (P = 0.001 for linearity). Conclusions: In the present study, increased CitH3 levels were positively associated with extensive WMLs in ischemic stroke patients, indicating a role of neutrophil extracellular traps formation in the pathogenesis of WMLs.

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Circulating lipocalin‐2 as a novel biomarker for early neurological deterioration and unfavorable prognosis after acute ischemic stroke

et al. 2023

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Introduction Lipocalin‐2 (LCN2) is an acute‐phase protein that could mediate neuroinflammation after brain injury. We aimed to evaluate if LCN2 level was associated with early neurological deterioration (END) in acute ischemic stroke patients, thus hindering clinical recovery. Methods We conducted a prospective study of acute ischemic stroke patients between June 2021 and February 2022. Serum LCN2 concentration was measured after admission using an enzyme‐linked immunosorbent assay. Outcomes included END and 90‐day poor functional outcome (modified Rankin Scale 3‐6). The National Institutes of Health Stroke Scale increment ≥4 points within 72 h after admission was defined as END. Results A total of 253 acute ischemic stroke patients (mean age, 65.2 ± 13.4 years; 64.0% male) were recruited. In the multivariate adjustment, increased serum LCN2 levels (per 1‐SD increase of LCN2) were associated with a higher risk of END (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.20–2.25; p = .002) and 90‐day poor outcome (OR, 1.73; 95% CI, 1.22–2.45; p = .002). Restricted cubic splines found a linear relationship between LCN2 level and 90‐day unfavorable outcome (END, p = .001 for linearity; 90‐day poor outcome, p = .013 for linearity). Subgroup analysis further confirmed the significant association of LCN2 with clinical outcomes. Conclusions This study demonstrated that higher circulating LCN2 level was associated with an increased risk of early clinical worsening and 90‐day unfavorable outcomes in ischemic stroke patients.

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Circulating lipocalin‐2 as a novel biomarker for early neurological deterioration and unfavorable prognosis after acute ischemic stroke

Cited by 6 publications

References 49 publications

Higher High-Mobility Group Box-1 Levels are Associated with White Matter Lesions in Ischemic Stroke Patients

Higher High-Mobility Group Box-1 Levels are Associated with White Matter Lesions in Ischemic Stroke Patients

Association between Citrullinated Histone H3 and White Matter Lesions Burden in Patients with Ischemic Stroke

Circulating lipocalin‐2 as a novel biomarker for early neurological deterioration and unfavorable prognosis after acute ischemic stroke

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