Differences of Circulating Inflammatory Markers between Large- and Small Vessel Disease in Patients with Acute Ischemic Stroke

Abstract

Background: The difference of inflammatory response between the pathogenesis of cerebral large- and small vessel disease after stroke remains unclear. In present study, we aim to determine the association of circulating inflammatory markers with different stroke subtype.Methods: 99 patients with non-cardioembolic stroke were divided into large artery atherosclerosis (LAA) and small-artery occlusion (SAO) according to TOAST classification. A panel of plasma inflammatory markers including leukocyte, lymphocyte, CRP, fibrinogen, D-dimer, CD40L, IFN-γ, IL-1α, IL-1β, IL-6, IL-8, IL-17 and TNF-α were measured within 72 hours following cerebral ischemia. The relation of their levels in plasma with stroke subtype was further studied. All statistical data analysis was performed by SPSS 17.0 software.Results: We found that only CRP were closely associated with stroke subtype (p<0.05). Compared to SAO subgroup, the plasma levels of CRP was higher in LAA subgroup (p<0.05). The predictive efficiency of CRP more than 3.2 for LAA was 85.7% sensitivity. The influencing factor of CRP includes IL-6, lymphocyte, fibrinogen and D-dimer.Conclusion: LAA had a stronger activation of inflammation than SAO in the pathogenesis, which was associated with the changes of CRP.

Tranilast Treatment Attenuates Cerebral Ischemia‐Reperfusion Injury in Rats Through the Inhibition of Inflammatory Responses Mediated by NF‐κB and PPARs

“…IRI is usually associated with life‐threatening inflammatory responses, which is one of the leading causes of brain injury and mortality. In human patients who undergo a stroke, previous studies have determined the pro‐inflammatory cytokine profile after acute cerebral ischemia, including CD40L, interferon‐r, interleukin (IL)‐17, IL‐1, IL‐6, IL‐8, and tumor necrosis factor alpha (TNF‐α), which indicated that the protein levels of IL‐6, IL‐8, and TNF‐α were significantly increased in the plasma of patients who undergo a stroke. In addition, elevation of IL‐6 is correlated with the disease severity and the poor prognosis .…”

An Elevated High-Sensitivity C-Reactive Protein Level Is Associated with Unfavorable Functional Outcomes of Small-Artery Occlusion in Patients without Diabetes

“…In addition, we evaluated patient information using a hospital-based stroke registry from Tianjin, Northern China. Our patients showed a higher prevalence of diabetes than those included in studies by Zeng et al [21] and Lv et al [33] (19.4 and 33.7%, respectively), which included patients from Southern China, and the sample population in this study does not represent the general population of China. Regretfully, no reexamination of hs-CRP levels was conducted, and no hs-CRP data were available 3 months after stroke.…”

“…However, these studies may be affected by the inclusion of other stroke subtypes and do not reflect the etiological characteristics of patients diagnosed with SAO. Different stroke subtypes according to the TOAST classification exhibit different characteristics of inflammation; the lacunar subtype is associated with lower levels of inflammatory cytokines [7] and lower levels of CRP [21]. …”

The Role of Circulating Platelets Microparticles and Platelet Parameters in Acute Ischemic Stroke Patients

“…42,43 This may suggest that LAA subtype has more complex pathophysiology than SAO subtype. 37,44 Since circulating PMPs possess higher procoagulant properties than activated platelets 45 and can contribute to thrombin generation and clot formation. 46 Therefore, elevated level of circulating PMPs may involve in the progression of AIS and associate with cerebral injury in AIS.…”