Time course of inflammatory cytokines in acute ischemic stroke patients and their relation to inter-alfa trypsin inhibitor heavy chain 4 and outcome

Abstract

Background:Biomarker for prognosis of stroke is urgently needed for the management of acute ischemic stroke (AIS) patients.Objective:To evaluate the course of inflammatory cytokines in AIS patients and its comparison with inter-alfa trypsin inhibitor heavy chain 4 (ITIH4) and outcome after AIS.Materials and Methods:A panel of 12 inflammatory cytokines and ITIH4 were estimated in serial blood samples collected at admission, 24 h, 48 h, 72 h, 144 h and at discharge of AIS patients (n = 5).Results:Out of the 12 cytokines, only interleukin (IL)-2, tumor necrosis factor-alfa (TNF-α), IL-10, IL-6, IL-1B and IL-8 were in the measurable range of the kit (10 pg/mL). We found high IL-2 at admission, which decreased (P < 0.05) in the follow-up samples. TNF-α initially increases (P < 0.05) at 24 h followed by gradual decrease (P < 0.05) after 72 h. IL-10 decreases initially (P < 0.05) till 72 h as compared with its level at admission and then increases (P < 0.05) after 144 h. Similarly, ITIH4 was down-regulated in the early 72 h followed by further increase with improvement of the patient. ITIH4 correlates with IL-10 and computed tomography scan infarct volume. Serum IL-6, IL-1B and IL-8 increased in the AIS patients, but did not show any pattern.Conclusions:Serial measurement of IL-10, IL-2 and TNF-α and ITIH4 may be useful for the follow-up of clinical outcome after AIS.

Incidence and Clinical Outcome of Patients with Hypertensive Acute Ischemic Stroke: An Update from Tertiary Care Center of Central India

“…In our earlier studies, we have reported that (ITIH4) which is a 120-kDa serum protein, normally presents in the serum of healthy subjects but very low or absent in patients with AIS (Nayak et al, 2012). We also compared S-100ββ and NSE protein levels across the same time intervals and found that serum level of ITIH4 correlated with S-100ββ and NSE concentrations.…”

“…We also compared S-100ββ and NSE protein levels across the same time intervals and found that serum level of ITIH4 correlated with S-100ββ and NSE concentrations. Thus, ITIH4 could be a useful biomarker for prognosis of patients with AIS (Nayak et al, 2012; Kashyap et al, 2009). In the current study, we found that the levels of ITIH4 peptide 2 and 7 increased at the time of discharge as compared to its admission value in improved patients with AIS as compared to expired/dependent patients.…”

Astrocytes, therapeutic targets for neuroprotection and neurorestoration in ischemic stroke

“…Reactive astrocytes are traditionally thought to be detrimental to neurological outcome after stroke. Within minutes after injury, reactive astrocytes produce and release inflammatory mediators such as cytokines and chemokines, cytokines including IL-6, TNF-α, IL-1α and β and interferon γ (Basic Kes et al , 2008; Nayak et al , 2012; Orzylowska et al , 1999; Tuttolomondo et al , 2008). These cytokines may induce neuronal death (Venters et al , 2000) and contribute to infarct progression in the post-ischemic period, either directly or via induction of neurotoxic mediators such as nitric oxide (Stoll et al , 1998), and increased BBB permeability (Yang et al , 1999).…”

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

“…45 It has been proven that IL-6 is actually a key inflammatory marker in stroke; numerous studies proved a significant increase in the concentration of IL-6 in serum, which occurred within a few hours after the onset of ischemia, and lasted for up to 90 days after the stroke. 43,[46][47][48][49][50][51][52][53] It has also been observed that the mean concentration of IL-6 in serum in patients with a symptomatic ICA stenosis is significantly higher than in healthy individuals in the period between 15th and 154th day after the onset of cerebral ischemia symptoms. 54 Another study showed a similar phenomenon for up to 3 months after the onset of symptoms.…”