Pro-inflammatory and anti-inflammatory cytokines in acute ischemic stroke and their relation to early neurological deficit and stroke outcome

Introduction: Cardiovascular diseases including stroke are one of the most common causes of death. Their main cause is atherosclerosis and chronic inflammation in the body. An ischemic stroke may occur as a result of the rupture of unstable atherosclerotic plaque. Cardiovascular diseases are associated with uncontrolled inflammation. The inflammatory reaction produces chemical mediators that stimulate the resolution of inflammation. One of these mediators is lipoxins—pro-resolving mediators that are derived from the omega-6 fatty acid family, promoting inflammation relief and supporting tissue regeneration. Aim: The aim of the study was to review the available literature on the therapeutic potential of lipoxins in the context of ischemic stroke. Material and Methods: Articles published up to 31 January 2021 were included in the review. The literature was searched on the basis of PubMed and Embase in terms of the entries: ‘stroke and lipoxin’ and ‘stroke and atherosclerosis’, resulting in over 110 articles in total. Studies that were not in full-text English, letters to the editor, and conference abstracts were excluded. Results: In animal studies, the injection/administration of lipoxin A4 improved the integrity of the blood–brain barrier (BBB), decreased the volume of damage caused by ischemic stroke, and decreased brain edema. In addition, lipoxin A4 inhibited the infiltration of neutrophils and the production of cytokines and pro-inflammatory chemokines, such as interleukin (Il-1β, Il-6, Il-8) and tumor necrosis factor-α (TNF-α). The beneficial effects were also observed after introducing the administration of lipoxin A4 analog—BML-111. BML-111 significantly reduces the size of a stroke and protects the cerebral cortex, possibly by reducing the permeability of the blood–brain barrier. Moreover, more potent than lipoxin A4, it has an anti-inflammatory effect by inhibiting the production of pro-inflammatory cytokines and increasing the amount of anti-inflammatory cytokines. Conclusions: Lipoxins and their analogues may find application in reducing damage caused by stroke and improving the prognosis of patients after ischemic stroke.

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Pre Hospital Interventions to Improve Acute Ischemic Stroke Outcome in Urban Settings

Journal of the National Medical Association ◽

10.1016/j.jnma.2020.09.083 ◽

2020 ◽

Vol 112 (5) ◽

pp. S34

Author(s):

Shannon Anderson ◽

Danielle Thompson ◽

Erin Adams ◽

Marcus Spady ◽

Efosa Aghimien ◽

...

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Stroke Outcome ◽

Urban Settings

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Pre-Stroke Cholinesterase Inhibitor Treatment Is Beneficially Associated with Functional Outcome in Patients with Acute Ischemic Stroke and Pre-Stroke Dementia: The Fukuoka Stroke Registry

Cerebrovascular Diseases ◽

10.1159/000514368 ◽

2021 ◽

pp. 1-7

Author(s):

Yoshinobu Wakisaka ◽

Ryu Matsuo ◽

Kuniyuki Nakamura ◽

Tetsuro Ago ◽

Masahiro Kamouchi ◽

...

Keyword(s):

Cohort Study ◽

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Functional Outcome ◽

Neurological Deterioration ◽

Stroke Outcome ◽

Matched Cohort ◽

Poor Functional Outcome ◽

Stroke Registry ◽

Chei Treatment

Introduction: Pre-stroke dementia is significantly associated with poor stroke outcome. Cholinesterase inhibitors (ChEIs) might reduce the risk of stroke in patients with dementia. However, the association between pre-stroke ChEI treatment and stroke outcome remains unresolved. Therefore, we aimed to determine this association in patients with acute ischemic stroke and pre-stroke dementia. Methods: We enrolled 805 patients with pre-stroke dementia among 13,167 with ischemic stroke within 7 days of onset who were registered in the Fukuoka Stroke Registry between June 2007 and May 2019 and were independent in basic activities of daily living (ADLs) before admission. Primary and secondary study outcomes were poor functional outcome (modified Rankin Scale [mRS] score: 3–6) at 3 months after stroke onset and neurological deterioration (≥2-point increase in the NIH Stroke Scale [NIHSS] during hospitalization), respectively. Logistic regression analysis was used to evaluate associations between pre-stroke ChEI treatment and study outcomes. To improve covariate imbalance, we further conducted a propensity score (PS)-matched cohort study. Results: Among the participants, 212 (26.3%) had pre-stroke ChEI treatment. Treatment was negatively associated with poor functional outcome (odds ratio: 0.68 [95% confidence interval: 0.46–0.99]) and neurological deterioration (0.52 [0.31–0.88]) after adjusting for potential confounding factors. In the PS-matched cohort study, the same trends were observed between pre-stroke ChEI treatment and poor functional outcome (0.61 [0.40–0.92]) and between the treatment and neurological deterioration (0.47 [0.25–0.86]). Conclusions: Our findings suggest that pre-stroke ChEI treatment is associated with reduced risks for poor functional outcome and neurological deterioration after acute ischemic stroke in patients with pre-stroke dementia who are independent in basic ADLs before the onset of stroke.

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Acute Ischemic Stroke is Associated with Increased Serum Levels of Pro-inflammatory Cytokines

Indian Journal of Clinical Biochemistry ◽

10.1007/s12291-020-00892-8 ◽

2020 ◽

Author(s):

Bhagirath Ramawat ◽

Alvee Saluja ◽

Jayashree Bhatacharjee ◽

Anshuman Srivastava ◽

Rajinder K. Dhamija

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Inflammatory Cytokines ◽

Serum Levels ◽

Pro Inflammatory Cytokines

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PO23-749 ANTI-INFLAMMATORY ACTION OF SIMVASTATIN AND ROSUVASTATIN IN PATIENTS WITH ACUTE ISCHEMIC STROKE

Atherosclerosis Supplements ◽

10.1016/s1567-5688(07)71759-2 ◽

2007 ◽

Vol 8 (1) ◽

pp. 199

Author(s):

S. Antonopoulos ◽

M. Mylonopoulou ◽

A. Charamis ◽

S. Geracari ◽

C. Poulopoulou ◽

...

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Anti Inflammatory ◽

Inflammatory Action

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Therapeutically Targeting Neuroinflammation and Microglia after Acute Ischemic Stroke

BioMed Research International ◽

10.1155/2014/297241 ◽

2014 ◽

Vol 2014 ◽

pp. 1-9 ◽

Cited By ~ 40

Author(s):

Youngjeon Lee ◽

Sang-Rae Lee ◽

Sung S. Choi ◽

Hyeon-Gu Yeo ◽

Kyu-Tae Chang ◽

...

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Inflammatory Responses ◽

Secondary Injury ◽

Initial Event ◽

Stroke Models ◽

Anti Inflammatory ◽

Preclinical And Clinical Studies ◽

Multiple Receptor

Inflammation has a pivotal role in the pathogenesis of ischemic stroke, and recent studies posit that inflammation acts as a double-edged sword, not only detrimentally augmenting secondary injury, but also potentially promoting recovery. An initial event of inflammation in ischemic stroke is the activation of microglia, leading to production of both pro- and anti-inflammatory mediators acting through multiple receptor signaling pathways. In this review, we discuss the role of microglial mediators in acute ischemic stroke and elaborate on preclinical and clinical studies focused on microglia in stroke models. Understanding how microglia can lead to both pro- and anti-inflammatory responses may be essential to implement therapeutic strategies using immunomodulatory interventions in ischemic stroke.

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