IL-6 Plasma Levels Correlate With Cerebral Perfusion Deficits and Infarct Sizes in Stroke Patients Without Associated Infections

Abstract

Introduction: We aimed to investigate several blood-based biomarkers related to inflammation, immunity, and stress response in a cohort of patients without stroke-associated infections regarding their predictive abilities for functional outcome and explore whether they correlate with MRI markers, such as infarct size or location. Methods: We combined the clinical and radiological data of patients participating in two observational acute stroke cohorts: the PREDICT and 1000Plus studies. The following blood-based biomarkers were measured in these patients: monocytic HLA-DR, IL-6, IL-8, IL-10, LBP, MRproANP, MRproADM, CTproET, Copeptin, and PCT. Multiparametric stroke MRI was performed including T2 * , DWI, FLAIR, TOF-MRA, and perfusion imaging. Standard descriptive sum statistics were used to describe the sample. Associations were analyzed using Fischer's exact test, independent samples t- test and Spearmans correlation, where appropriate. Results: Demographics and stroke characteristics were as follows: 94 patients without infections, mean age 68 years (SD 10.5), 32.2% of subjects were female, median NIHSS score at admission 3 (IQR 2–5), median mRS 3 months after stroke 1 (IQR 0–2), mean volume of DWI lesion at admission 5.7 ml (SD 12.8), mean FLAIR final infarct volume 10 ml (SD 14.9), cortical affection in 61% of infarctions. Acute DWI lesion volume on admission MRI was moderately correlated to admission/maximum IL-6 as well as maximum LBP. Extent of perfusion deficit and mismatch were moderately correlated to admission/maximum IL-6 levels. Final lesion volume on FLAIR was moderately correlated to admission IL-6 levels. Conclusion: We found IL-6 to be associated with several parameters from acute stroke MRI (acute DWI lesion, perfusion deficit, final infarct size, and affection of cortex) in a cohort of patients not influenced by infections. Clinical Trial Registration: www.ClinicalTrials.gov , identifiers NCT01079728 and NCT00715533

<p>The Role of Selected Pro-Inflammatory Cytokines in Pathogenesis of Ischemic Stroke</p>

“…[56][57][58] The relationship between the level of IL-6 in serum, the severity of neurological deficit as well as prognosis concerning patients with an acute ischemic stroke and the volume of an ischemic stroke is an object of interest of many researchers. Many authors indicate that the increase in the concentration of IL-6 in serum within the first 24 hrs following a stroke is associated with a deterioration of patients' functional state 43,55,59,60 and greater spectrum covered by the lesion volume 61,62 and they consider the level of IL-6 to be a reliable prognostic factor in the acute phase of ischemic stroke. It has been shown that the increase in the concentration of IL-6 in serum on the 1st and 6th day after the ischemic stroke is associated with long-term post-stroke prognosis post-stroke disability degree and mortality at 3 months and/or 1 year following a stroke.…”

Inflammatory and stress markers predicting pneumonia, outcome, and etiology in patients with stroke

“…Both of these conditions are correlated with infarction size and consequently stroke severity, as recently shown with interleukin 6. 21 Of interest, cardioembolic stroke was associated with higher levels of most of the examined biomarkers compared with other stroke etiologies. Discrimination was best for MRproANP and was independent of stroke severity in multivariate testing, possibly relating to its properties as a cardiac hemodynamic stress marker.…”

“…Although it would have been of great interest to compare these blood-borne biomarkers with imaging findings, we only had imaging data on 94 patients, details of which have been published previously. 21 Furthermore, other clinical parameters are known to partly predict the outcome of stroke that we could not account for in our analysis. The studies contributing data to this analysis did not record certain metabolic measures (such as body mass index, waist circumference, metabolic syndrome, lipid profile, and exercise), comorbidities (liver steatosis, gout, chronic kidney disease, depression, valve disorder, and coronary or peripheral artery disease) and other biomarkers (C-reactive protein and fasting glucose).…”

Diagnostic Value of Serum Biomarkers for Differentiating Central and Peripheral Causes of Acute Vertigo

“…Aside from its importance in neural development and cell survival, BDNF appears essential for the molecular mechanisms of synaptic plasticity (20), and neuroprotective actions of BDNF were suggested in a rat model of transient forebrain ischemia (24). Interleukin-6 (IL-6), a major cytokine that stimulates the synthesis of acute-phase proteins, is regulated by the CNS, and is associated with several parameters of acute stroke (25,26). This evidence supports the hypothesis that serum biomarkers can help to distinguish between CV and PV.…”