Serum levels of cytokines and C-reactive protein in acute ischemic stroke patients, and their relationship to stroke lateralization, type, and infarct volume

Abstract

There is increasing evidence that inflammation plays an important role in the progression of acute ischemic stroke (AIS). The primary aims of this study were to examine the serum levels of 13 cytokines, C-reactive protein (CRP), glucose, and hemoglobin in AIS patients, and their relationship to stroke lateralization, type, and infarct volume. Forty-five patients with AIS were evaluated. Blood samples were taken within 72 h, and volumetric analyses performed within 1–7 days after AIS onset. Cytokines were measured in serum from all patients and from 40 control subjects using Luminex Bio-Plex XMap technology. The levels of interleukin (IL)-1ra (p < 0.001), IL-6 (p < 0.001), IL-8 (p < 0.001), IL-9 (p = 0.038), IL-10 (p = 0.001), IL-12 (p = 0.001), IL-18 (p < 0.001), and GRO-α (CXCL1) (p = 0.017) were significantly higher in the AIS patients than in the controls. The IL-8 level was significantly correlated with age in the patient group (r = 0.52, p < 0.001). None of the variables were found to be associated with stroke lateralization. Infarct volume was significantly positively correlated with CRP level (r = 0.47, p = 0.005). Patients with radiologically confirmed infarctions had significantly elevated serum levels of GRO-α (p = 0.023). The cytokine profile of the AIS patients supports not only earlier findings of a proinflammatory response but also early activation of endogenous immunosuppressive mechanisms. Novel findings of this study are elevated serum levels of IL-9 and GRO-α. Elevated GRO-α in AIS patients with radiologically confirmed infarctions suggests that GRO-α is specific for stroke of known etiology. Our results indicate that CRP plays an important role in the progression of cerebral tissue injury.

Serum amyloid A, fetuin-A, and pentraxin-3 levels in patients with ischemic stroke: novel prognostic biomarkers?

“…Clinical and experimental studies suggest that inflammatory mechanisms play an important role in the pathogenesis of IS (18,21). More studies are performed to explain the inflammatory process in AIS and to make better treatment decisions and individualization of therapy nowadays (1,3,22,23). The biochemical parameters used routinely also were used in these studies (21).…”

“…Studies have shown that CRP was strongly associated with the prognostic outcome after AIS (1,19,24,25). Ormstad et al (1) found that CRP played an important role in the progression of cerebral tissue injury.…”

“…Ormstad et al (1) found that CRP played an important role in the progression of cerebral tissue injury. We found a significant elevation in CRP only in the third tertile of SAA.…”

“…There is a significant contribution of inflammation in the progression of acute ischemic stroke (AIS) (1). Since stroke is a disease with high costs, prediction of the risk for it with an outlook toward the severity of the disease and prognosis is necessary for accurate care and designation of limited health resources (2).…”

Roles of Pro- and Anti-inflammatory Cytokines in Traumatic Brain Injury and Acute Ischemic Stroke

“…Cytokines have been broadly classiied based on their receptor homology, their overall action as pro-versus anti-inlammatory, or their membership into the tumor necrosis factor, lymphokine, interleukin (IL-) and interferon (IFN-) families [9]. Cytokine receptor classes include the tumor necrosis factor receptor family, interleukin-1 receptor family, Class-II cytokine receptor family which includes interferon receptors and the IL-10 receptor, and Class-I or hematopoietin cytokine receptors which includes receptors of the IL-2, IL-3, and IL-6 family, as well as homodimeric receptors [9,[27][28][29][30].Similar to their efects in the periphery, CNS cytokines are known to regulate the production of other cytokines. They can also alter the BBB, recruit inlammatory cells and inluence neurotransmiter metabolism (monoamines, serotonin, dopamine and glutamate) [31][32][33].…”