Plasma α-Melanocyte Stimulating Hormone Predicts Outcome in Ischemic Stroke

Abstract

Background and Purpose α-Melanocyte stimulating hormone (α-MSH) is an endogenously produced neuropeptide derived from the same precursor as adrenocorticotropic hormone. α-MSH has profound immunomodulatory properties and may also be neuroprotective. Nothing is known about α-MSH and changes in its plasma concentrations in patients with acute ischemic stroke. Methods In this prospective observational study, plasma concentrations of α-MSH, adrenocorticotropic hormone, cortisol, and interleukin 6 were assessed longitudinally over the course of 1 year after stroke onset in 111 patients. Logistic regression was used to the effect of initial plasma α-MSH, adrenocorticotropic hormone, cortisol, and interleukin 6 on long-term outcome. Results There was an early decrease in plasma α-MSH in patients with severe stroke (National Institutes of Health Stroke Scale ≥17) that normalized over the course of the year; these same patients evidenced elevations in plasma cortisol and interleukin 6. Higher initial plasma α-MSH, but not adrenocorticotropic hormone, cortisol, or interleukin 6, was independently predictive of good long-term outcome. Conclusions This research is the first to study endogenous changes in plasma α-MSH after stroke. The independent effect of early plasma α-MSH on stroke outcome, as well as a growing body of experimental data demonstrating improved stroke outcome with exogenous α-MSH administration, suggests a potential therapeutic role for α-MSH in the treatment of stroke.

Single Administration of Tripeptide α-MSH(11–13) Attenuates Brain Damage by Reduced Inflammation and Apoptosis after Experimental Traumatic Brain Injury in Mice

“…Decreased α-MSH plasma levels were associated with poor neurologic outcome in a rat model of middle cerebral artery occlusion and also in patients with ischemic stroke [24], [25]. Also in humans, α-MSH concentrations were lessened in critically injured trauma patients as well as after subarachnoid hemorrhage or TBI [26], [27].…”

Myelin basic protein autoantibodies, white matter disease and stroke outcome

“…The characteristics of this study population have been described elsewhere (Becker et al, 2011; Tanzi et al, 2011; Zierath et al, 2011). Consistent with these previous papers, patients were categorized according to baseline stroke severity (mild = NIHSS ≤5, moderate = NIHSS 6–16, severe = NIHSS≥17).…”

Both MC 1 and MC 3 Receptors Provide Protection From Cerebral Ischemia-Reperfusion–Induced Neutrophil Recruitment

“…The ability of MCs to suppress pro-inflammatory responses whilst enhancing anti-inflammatory signals suggests that these receptors form an endogenous pro-resolving system. In humans α-MSH concentrations increases in myocardial infarction and infection 2 and higher melanocortin levels correlate with better outcome in stroke patients 18 . Thus, given the results from the present study the melanocortin receptor system may prove a valuable therapeutic target for the treatment of stroke.…”