The importance of selected markers of inflammation and blood-brain barrier damage for short-term post-stroke prognosis

Abstract

Acute cerebral ischemia triggers local and systemic immune response. The aims of this project was to assess the blood serum concentration of the markers of inflammation and markers of the blood brain barrier damage on the first day of ischemic stroke, and the mutual correlations between these marker levels. Methods Our prospective study included 138 patients with first-in-life stroke, who were analyzed according to: plasma concentration of the following markers on the first day of stroke: Il-2 and IL-6, S100B, TNF alfa, GRN, NSE, uPA, VEGF, BDNF, CRP, leucocyte and thrombocyte counts; their neurological status on the first day of stroke (NIHSS) and their functional status at 30 days following stroke (mRS). Result The study included 138 patients with mean age: 73.11 ± 11.48 [36-103]. Patients with a higher score on the NIHSS than those obtaining lower scores showed significantly higher concentrations of TNF-alpha, WBC, CRP, NSE, IL-6 and S100B. Patients with a higher score on the mRS than those obtaining lower scores showed significantly higher concentrations of WBC, CRP, GRN, IL-6, S100B. Factors with an independent influence on the neurological status on the first day of stroke were: sex, WBC, PLT, CRP, S100B and IL-6 levels. Atrial fibrillation, leukocyte count, CRP, NSA, uPA, interleukin 6 and S100B showed an independent impact on the functional status on the 30th day of stroke. Patients with symptomatic atherosclerosis of carotid/cerebral and/or coronary arteries, as compared to others, were older (p= 0.003) and had higher levels of CRP, Il-6, and S100B. In each case, the differences were statistically significant. Conclusions The concentration of Il-6 and S100B on the first day of stroke are significant for both the neurological status and the functional status in the acute period of the disease. Increased CRP and leukocyte count are associated with a worse prognosis regarding the course of acute stroke. The expression of pro-inflammatory agents and markers of blood-brain barrier damage in the acute phase of stroke is more prominent in patients with symptomatic atherosclerosis than in patients with no clinical features of atherosclerosis.

Prognostic significance of plasma IL-2 and sIL-2Rα in patients with first-ever ischaemic stroke

“…To date, a number of studies have demonstrated that the blood levels of cytokines, chemokines, and growth factors, including C-reactive protein, TNF-α, IL-6 and IL-10, are associated with outcomes in AIS patients [14][15][16]. Although IL-2 is one of the most frequently studied cytokines in stroke patients, the conclusions are ambiguous and inconsistent with the results of experimental studies [17][18][19]. This might be due to the complexity of IL-2/IL-2R autocrine loops.…”

Relationship between HIF-1α and apoptosis in rats with traumatic brain injury and the influence of traditional Chinese medicine Sanqi

“…When the brain is injured and ischemic, the blood-brain barrier is damaged, which aggravates brain edema, ischemia and hypoxia, and further causes brain tissue damage (Lasek-Bal et al, 2019). The destruction of the blood-brain barrier is a key link in the aggravation of secondary brain injury.…”

Non-stenosing Carotid Atherosclerosis and Arterial Stiffness in Embolic Stroke of Undetermined Source

“…Lastly, our cohort of patients with non-NSA-ESUS had lower levels of CRP in comparison with strokes due to atherosclerosis; instead NSA-ESUS seem to have intermediate values, but not significantly different in comparison with both non-NSA ESUS and atherosclerotic strokes. It is well-known the pathogenic link among inflammation, atherosclerosis, and arterial stiffness (24), thus these intermediate values suggest a further similarity between NSA-ESUS and strokes due to atherosclerosis.…”