scholarly journals Interleukin 6 promoter 174 G/C polymorphisms in acute ischemic stroke: G allele is protective but not associated with IL-6 levels or stroke outcome

2016 ◽  
Vol 293 ◽  
pp. 22-27 ◽  
Author(s):  
J. Yan ◽  
Greer JM ◽  
McCombe PA
Author(s):  
Al Rasyid ◽  
Salim Harris ◽  
Muhammad Kurniawan ◽  
Taufik Mesiano ◽  
Rakhmad Hidayat

     THE EFFECT OF INTERLEUKIN-6 AND NEURON SPECIFIC ENOLASE LEVEL ON ACUTE ISCHEMIC STROKE OUTCOME WITH PACS AND LACS SUBTYPEABSTRACTIntroduction: Brain blood flow disruption  in ischemic stroke will trigger  cells damage  cascade  and  caused infarction. Interleukin-6 (IL-6) and neuron specific enolase (NSE) are brain cells damage marker that can be markers of acute ischemic stroke outcome.Aim: To investigate the effect of IL-6 and NSE levels on acute ischemic stroke outcome and its interacting factors.Methods: An observational cohort study on ischemic stroke patients with onset ≤3 days in several hospitals in Jakarta and Depok in 2014. Medical history and physical examination were carried out as well as laboratory parameters; hematocrit, fibrinogen, low density lipoprotein (LDL), high density lipoprotein (HDL), triglyceride, IL-6, and NSE. The National Institute of Health Stroke Scale (NIHSS) were assessed ≤72 hours of onset and 7 days along with Modified Rankin Scale (mRS) at 1 month of onset. Bivariate and multivariate logistic regression were done to investigate the association of IL-6 and NSE with stroke outcome and other factors.Results: One-hundred thirty-five subjects were included, mostly male (62%), with age mean 59,4±10,7 years and subtype PACS (76%). Interleukin-6 and NSE level were elevated in 61,5% and 21,5% subjects. Interleukin-6 and fibrinogen influenced the mRS, while diabetes and fibrinogen influenced the NIHSS. NSE serum didn’t show any association with mRS nor NIHSS, but influenced by dyslipidemia.Discussion: There was a tendency of worse outcome on high IL-6 level patients, although by multivariate analysis IL-2 alone was not sufficient enough as prognostic marker in acute ischemic stroke outcome. Neuron specific enolase serum didn’t show any association with acute stroke outcome due to also influenced by sex, smoking, and fibrinogen levels.Keywords: Acute ischemic stroke, IL-6, NSE, outcomeABSTRAKPendahuluan: Gangguan aliran darah otak pada stroke iskemik akut akan memicu kaskade kerusakan sel otak yang menyebabkan infark dan inflamasi. Interleukin-6 (IL-6) dan neuron specific enolase (NSE) merupakan penanda kerusakan sel otak yang dapat menjadi penanda luaran stroke iskemik akut.Tujuan: Mengetahui pengaruh kadar IL-6 dan NSE pada luaran stroke iskemik akut serta faktor-faktor yang memengaruhinya.Metode: Penelitian kohort observasional terhadap pasien stroke iskemik akut dengan awitan ≤3 hari yang dirawat di beberapa RS di Jakarta dan Depok pada tahun 2014. Dilakukan anamnesis dan pemeriksaan fisik serta pemeriksaan hematokrit, fibrinogen, low density lipoprotein (LDL), high density lipoprotein  (HDL), trigliserida, IL-6, dan NSE serum. Dilakukan pemeriksaan National Institute of Health Stroke Scale (NIHSS) awal awitan ≤72 jam dan 7 hari serta modified rankin scale (mRS) pada 1 bulan. Analisis statistik bivariat dan regresi logistik multivariat dilakukan untuk mengetahui hubungan kadar IL-6 dan NSE dengan luaran stroke serta hubungannya terhadap faktor-faktor lainnya.Hasil: Didapatkan 135 subjek yang mayoritas laki-laki (62%) dengan rerata usia 59,4±10,7 tahun dan subtipe PACS (76%). Peningkatan kadar IL-6 dan NSE ditemukan pada 61,5% dan 21,5% subjek. Luaran berdasarkan skor mRS dipengaruhi oleh kadar IL-6 dan fibrinogen, sedangkan  berdasarkan NIHSS dipengaruhi oleh diabetes melitus dan fibrinogen. Kadar NSE tidak berhubungan dengan mRS dan NIHSS, namun dipengaruhi oleh status dislipidemia.Diskusi: Terdapat kecenderungan luaran buruk pada kadar IL-6 tinggi, namun dengan analisis multivariat IL-6 belum bisa menjadi penanda prognosis luaran stroke iskemik akut. Kadar NSE serum tidak berperan terhadap luaran stroke iskemik akut, oleh karena juga dipengaruhi oleh jenis kelamin, merokok, dan kadar fibrinogen.Kata kunci: Stroke iskemik akut, IL-6, neuron specirefic enolase, luaran


2020 ◽  
Vol 112 (5) ◽  
pp. S34
Author(s):  
Shannon Anderson ◽  
Danielle Thompson ◽  
Erin Adams ◽  
Marcus Spady ◽  
Efosa Aghimien ◽  
...  

2021 ◽  
pp. 1-7
Author(s):  
Yoshinobu Wakisaka ◽  
Ryu Matsuo ◽  
Kuniyuki Nakamura ◽  
Tetsuro Ago ◽  
Masahiro Kamouchi ◽  
...  

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.


2017 ◽  
Vol 31 (7) ◽  
pp. 638-647 ◽  
Author(s):  
Daryoush Savadi Oskouie ◽  
Ehsan Sharifipour ◽  
Homayoun Sadeghi Bazargani ◽  
Mazyar Hashemilar ◽  
Masoud Nikanfar ◽  
...  

Neurology ◽  
2000 ◽  
Vol 54 (3) ◽  
pp. 679-679 ◽  
Author(s):  
A. M. Buchan ◽  
P. A. Barber ◽  
N. Newcommon ◽  
H. G. Karbalai ◽  
A. M. Demchuk ◽  
...  

2019 ◽  
Vol 10 (01) ◽  
pp. 1-14 ◽  
Author(s):  
Hasnaa A. Abo-Elwafa ◽  
Hazem K. Ibrahim ◽  
Hassan M. El-Nady ◽  
Asmaa H. Abbas

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254228
Author(s):  
Hany M. Aref ◽  
Hossam Shokri ◽  
Tamer M. Roushdy ◽  
Fatma Fathalla ◽  
Nevine M. El Nahas

Background In the current study we investigated the causes of pre-hospital delay as this can compromise the patient’s chance to receive thrombolytic therapy and thus impact stroke outcome. Methods We surveyed 254 patients regarding reasons for delayed and early arrival to hospital after acute ischemic stroke. The survey was performed over five months, spanning a period pre- and during COVID-19 (between December 7, 2019 and May 10, 2020). Results A total of 71.2% of patients arrived beyond four hours of onset of ischemic stroke. The commonest cause for delay pre-Covid-19 was receiving treatment in a non-stroke hospital, while that during COVID-19 was fear of infection and lock down issues. Not realizing the urgency of the condition and stroke during sleep were common in both periods. Early arrival because of the patient’s previous experience with stroke accounted for approximately 25% of cases in both periods. The effect of media was more evident during COVID-19, accounting for 47.7% of cases. Conclusion Pre-hospital delay secondary to misperception of the urgency of stroke and management in a non-stroke hospital reflect the lack of awareness among the public and medical staff. This concept is emphasized by early arrival secondary to previous experience with stroke and the pronounced effect of media in the time of COVID-19.


2021 ◽  
Vol 12 ◽  
Author(s):  
Fangfang Li ◽  
Ping Liu ◽  
Yuyou Huang ◽  
Lingzhi Li ◽  
Sijia Zhang ◽  
...  

Hepatocyte growth factor (HGF) is a potential prognostic factor for acute ischemic stroke (AIS). In this study, we sought to validate its earlier predictive accuracy within 24 h for first-ever AIS. Moreover, as HGF interacts with interleukins, their associations may lead to novel immunomodulatory therapeutic strategies. Patients with first-ever AIS (n = 202) within 24 h were recruited. Plasma HGF and related interleukin concentrations were measured by multiplex immunoassays. The primary and secondary outcomes were major disability (modified Rankin scale score ≥3) at 3 months after AIS and death, respectively. Elastic net regression was applied to screen variables associated with stroke outcome; binary multivariable logistic analysis was then used to explore the relationship between HGF level and stroke outcome. After multivariate adjustment, upregulated HGF levels were associated with an increased risk of the primary outcome (odds ratio, 7.606; 95% confidence interval, 3.090–18.726; p < 0.001). Adding HGF to conventional risk factors significantly improved the predictive power for unfavorable outcomes (continuous net reclassification improvement 37.13%, p < 0.001; integrated discrimination improvement 8.71%, p < 0.001). The area under the receiver operating characteristic curve value of the traditional model was 0.8896 and reached 0.9210 when HGF was introduced into the model. An elevated HGF level may also be a risk factor for mortality within 3 months poststroke. The HGF level was also positively correlated with IL-10 and IL-16 levels, and HGF before interaction with all interleukins was markedly negatively correlated with the lymphocyte/neutrophil ratio. HGF within 24 h may have prognostic potential for AIS. Our findings reinforce the link between HGF and interleukins.


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