Inflammatory factors are associated with early neurological deterioration in acute ischemic stroke patients receiving endovascular therapy-The AISRNA study

Abstract

Background: This study aimed to explore several peripheral blood-based markers related to inflammatory response in a total of 85 patients with acute ischemic stroke (AIS) caused by large artery occlusion in the anterior circulation receiving endovascular therapy (EVT) from the AISRNA study regarding the association between inflammatory factors and early neurological deterioration (END), and investigated whether their time course correlated with END after EVT.Methods: We collected baseline characteristics of 85 AIS patients participating in an observational acute stroke cohort: the AISRNA study. The following inflammatory factors were measured in these participants: interleukin-2 [IL-2], IL-4, IL-6, IL-10, tumor necrosis factor-α [TNF-α], and interferon-γ [IFN-γ]. The National Institute of Health Stroke Scale score increase of ≥4 within 24 hours after EVT defined as END.Results: IL-6 and IL-10 were higher in patients with END compared to those with non-END (P<0.01), and they were also associated with risk factors of END after EVT. Furthermore, we found that the area under curves (AUCs) of IL-6 and IL-10 for predicting END were 0.791 (0.689-0.871), and 0.564 (0.452-0.671), respectively. Adjusting for age, sex, and atrial fibrillation, the odds ratios (ORs; 95% confidence interval) for incident END for IL-6 and IL-10 were 1.83 (1.08-6.36) and 1.15 (1.02-1.30), respectively. Additionally, we found significant changes over time in the expression levels of IL-4, IL-6, and IL-10 in patients undergoing END compared with non-END (P<0.05).Conclusions: IL-6 and IL-10 levels on admission are significantly associated with END after EVT, and time course of IL-4, IL-6, and IL-10 is correlated with stroke progression. Further study of molecular mechanisms on peripheral immunomodulation in AIS would be helpful.Trial registration: ClinicalTrials.gov NCT04175691. Registered November 21, 2019.