Changes of DCE‐MRI Parameters in Patients with Rheumatoid Arthritis before and after Therapy and Their Value for the Efficacy Evaluation of Patients

Objective. To explore the changes of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters in patients with rheumatoid arthritis (RA) before and after therapy and their value for the efficacy evaluation of patients. Methods. Totally, 90 patients with RA confirmed in our hospital between January 2018 and January 2020 were enrolled. All of them were examined with a Siemens Magnetom Avanto 1.5T imaging system, and data about the rate of enhancement in early stage (REE) and steep slope maximum (SSmax) were obtained. Then, the disease activity score in 28 joints (DAS-28), REE, and SSmax were analyzed, and the associations of SSmax and REE with erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and DAS-28 were investigated. Additionally, the patients were assigned to the acute-stage group and the chronic-stage group according to their time-signal intensity curves after therapy, and the two groups were compared in SSmax, REE, ESR, CRP, and DAS-28. Corresponding receiver operating characteristic (ROC) curves were drawn for the analysis of potential markers for efficacy improvement in patients. Results. After therapy, REE, SSmax, ESR, DAS-28, and CRP in the synovium of all patients declined greatly (all P < 0.05 ), with higher levels observed in the acute-stage group than those in the chronic-stage group (all P < 0.05 ). SSmax and REE of patients were positively bound up with their ESR, CRP, and DAS-28 (all P < 0.05 ). Additionally, according to ROC curve-based analysis, both SSmax and REE can be adopted as biological indexes for distinguishing between patients at the acute phase from those at the chronic stage, and joint detection of them can boost the sensitivity of DAS-28. Conclusion. The SSmax and REE levels in RA patients after treatment were significantly decreased, and the levels in patients in the chronic phase were lower than those in patients in the acute phase. SSmax and REE are highly expressed in RA patients, and the combined detection can enhance the value of DAS-28 in the assessment of RA, and it is worthy of clinical promotion.

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AB0655 RHEUMATOID ARTHRITIS ACTIVITY BEFORE AND AFTER COVID-19 LOCKDOWN PERIOD

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.576 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1360.1-1360

Author(s):

M. Jordhani ◽

D. Ruci ◽

F. Skana ◽

E. Memlika

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Musculoskeletal Diseases ◽

Statistical Tests ◽

Laboratory Data ◽

World Population ◽

Chronic Patients ◽

Das 28 ◽

Significant Difference ◽

Before And After

Background:The COVID-19 global pandemic has had a great impact on world population due to morbidity, mortality and restriction measures in order to stop the progression of COVID-19.Patients with rheumatic and musculoskeletic diseases, and especially rheumatoid arthritis (RA) patients, being one of the vulnerable classes of chronic patients, were recommended to follow the government’s rules1.Objectives:The aim of this study was to evaluate DAS-28-ESR in patients with rheumatoid arthritis before and after lockdown period.Methods:This is a multi-center observational study including 85 patients which were evaluated before and after lockdown for their disease activity score according to DAS-28-ESR score. They had been diagnosed with rheumatoid arthritis more than 5 years ago. A thorough physical examination was performed before and after the lockdown period. It included examination of tender and swollen joints and patient’s global health. They were completed with all required laboratory data, including erythrosedimentation rate. For a more accurate calculation, DAS-28-ESR was used in an electronic version. Patients with other inflammatory or infective diseases were excluded from the study. All data were statistically evaluated using statistical tests such as t-student test.Results:The first group (the one before lockdown) had an average DAS-28-ESR of 4.7 while after the lockdown period, the average DAS-28-ESR was 5.16.After statistically evaluating all data, it was found that there exists a significant difference between DAS-28-ESR score before and after COVID-19 lockdown (p=0.0011).Conclusion:Our study showed that lockdown period due to COVID-19 pandemic, has aggravated disease activity in patients with Rheumatoid Arthritis. This may be consequence of various causes such as physical inactivity and difficulty to follow-up or to take the medication properly.References:[1]Landewé RB, Machado PM, Kroon F, et al, EULAR provisional recommendations for the management of rheumatic and musculoskeletal diseases in the context of SARS-CoV-2, Annals of the Rheumatic Diseases 2020;79:851-858.Disclosure of Interests:None declared.

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Determinants of Persistent Post COVID-19 symptoms: Value of a Novel COVID-19 symptoms score

10.1101/2020.11.11.20230052 ◽

2020 ◽

Author(s):

Islam Galal ◽

Aliae AR Mohamed Hussein ◽

Mariam T Amin ◽

Mahmoud M Saad ◽

Hossam Eldeen E Zayan ◽

...

Keyword(s):

Symptom Score ◽

Acute Phase ◽

Acute Attack ◽

Cross Sectional Study ◽

Acute Stage ◽

Cross Sectional ◽

Before And After ◽

History Of ◽

The Mean ◽

Main Determinants

AbstractBackgroundBeing a newly emerging disease little is known about its long-lasting post COVID-19 consequences. Aim of this work is to assess the frequency, patterns and determinants of persistent post COVID-19 symptoms and to evaluate the value of a proposed Novel COVID-19 symptoms score. Patients with confirmed COVID-19 in the registry were included in a cross sectional study. The patient demographics, comorbid disorders, the mean duration since the onset of the symptoms, history of hospital or ICU admittance, and treatment taken during acute state, as well as symptoms score before and after convalescence were recorded.ResultsThe most frequent constitutional and neurological symptoms were myalgia (60.0%), arthralgia (57.2%), restriction of daily activities (57.0%), sleeping troubles (50.9%), followed by anorexia (42.6%), chest pain (32.6%), gastritis (32.3%), cough (29.3%) and dyspnea (29.1%). The mean total score of acute stage symptoms was 31.0 ± 16.3 while post COVID 19 symptoms score was 13.1±12.6 (P<0.001). The main determinants of the persistent post COVID-19 symptoms were the need for oxygen therapy (P<0.001), pre-existing hypertension (P=0.039), chronic pulmonary disorders (P=0.012), and any chronic comorbidity (P=0.004). There was a correlation between the symptom score during the acute attack and post COVID-19 stage (P<0.001, r=0.67). The acute phase score had 83.5% sensitivity and 73.3% specificity for the cutoff point > 18 to predict occurrence of Post-COVID-19 symptoms.ConclusionsCOVID-19 can present with a diverse spectrum of long-term post COVID-19 symptoms. Increased acute phase symptom severity and COVID-19 symptom score > 18 together with the presence of any comorbid diseases increase the risk for persistent post COVID-19 manifestations and severity.

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Comparative Analysis of Approaches and Treatment Results of Patients with Early and Nonearly Rheumatoid Arthritis

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.693 ◽

2019 ◽

Vol 7 (17) ◽

pp. 2802-2806

Author(s):

Olga V. Pashanova ◽

Natalia B. Lopatina ◽

Sergey A. Krivosheev ◽

Natalia Y. Baranova

Keyword(s):

Rheumatoid Arthritis ◽

Comparative Analysis ◽

Health Assessment ◽

Laboratory Research ◽

Treatment Results ◽

Hospital Department ◽

Das 28 ◽

Before And After ◽

Associated Conditions ◽

Score Index

The article presents the results of a comparative analysis of different therapy regimens impact on the effectiveness of treatment of patients with early and late rheumatoid arthritis in steady-state. Data on ongoing basis anti-inflammatory therapy of rheumatoid arthritis and the treatment of associated conditions were obtained by continuous copying from case histories of hospital department patients. The observations lasted 12 months. The activity of rheumatoid arthritis before and after the treatment was determined by the DAS 28 (Disease Activity Score) index. The treatment results were evaluated as per the laboratory research and the DAS 28 index, including the counting of painful and swollen joints, erythrocyte sedimentation rate, and health assessment of the patient on a visual analogue scale.

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Determinants of persistent post-COVID-19 symptoms: value of a novel COVID-19 symptom score

Egyptian Journal of Bronchology ◽

10.1186/s43168-020-00049-4 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Islam Galal ◽

Aliae A. R. Mohamed Hussein ◽

Mariam T. Amin ◽

Mahmoud M. Saad ◽

Hossam Eldeen E. Zayan ◽

...

Keyword(s):

Symptom Score ◽

Acute Phase ◽

Acute Attack ◽

Cross Sectional Study ◽

Acute Stage ◽

University Hospital ◽

Cross Sectional ◽

Before And After ◽

The Mean ◽

Main Determinants

Abstract Background Being a newly emerging disease, little is known about its long-lasting post-COVID-19 consequences. The aim of this work is to assess the frequency, patterns, and determinants of persistent post-COVID-19 symptoms and to evaluate the value of a proposed novel COVID-19 symptom score. Patients with confirmed COVID-19 in a hospital-based registry were included in a cross-sectional study (the hospitals including Assiut University Hospital, Assiut Chest Hospital, Aswan University Hospital, and Aswan Specialized Hospital). The patient demographics, comorbid disorders, the mean duration since the onset of the symptoms, history of hospital or ICU admittance, and the treatment taken during the acute state, as well as symptom score before and after convalescence, were recorded. Results The most frequent constitutional and neurological symptoms were myalgia (60.0%), arthralgia (57.2%), restriction of daily activities (57.0%), and sleeping troubles (50.9%), followed by anorexia (42.6%), chest pain (32.6%), gastritis (32.3%), cough (29.3%), and dyspnea (29.1%). The mean total score of acute stage symptoms was 31.0 ± 16.3 while post-COVID 19 symptom score was 13.1 ± 12.6 (P < 0.001). The main determinants of the persistent post-COVID-19 symptoms were the need for oxygen therapy (P < 0.001), pre-existing hypertension (P = 0.039), chronic pulmonary disorders (P = 0.012), and any chronic comorbidity (P = 0.004). There was a correlation between the symptom score during the acute attack and post-COVID-19 stage (P < 0.001, r = 0.67). The acute phase score had 83.5% sensitivity and 73.3% specificity for the cutoff point > 18 to predict occurrence of post-COVID-19 symptoms. Conclusions COVID-19 can present with a diverse spectrum of long-term post-COVID-19 symptoms. Increased acute phase symptom severity and COVID-19 symptom score > 18 together with the presence of any comorbid diseases increase the risk for persistent post-COVID-19 manifestations and severity.

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Differential Efficacy of Ketamine in the Acute versus Chronic Stages of Complex Regional Pain Syndrome in Mice

Anesthesiology ◽

10.1097/aln.0000000000000889 ◽

2015 ◽

Vol 123 (6) ◽

pp. 1435-1447 ◽

Cited By ~ 19

Author(s):

Maral Tajerian ◽

David Leu ◽

Phillip Yang ◽

Ting Ting Huang ◽

Wade S. Kingery ◽

...

Keyword(s):

Complex Regional Pain Syndrome ◽

Acute Phase ◽

Chronic Phase ◽

Pain Syndrome ◽

Acute Stage ◽

Cast Immobilization ◽

Nociceptive Sensitization ◽

Dependent Protein ◽

Acting Agent ◽

Related Proteins

Abstract Background Complex regional pain syndrome (CRPS) is a painful, disabling, and often chronic condition, where many patients transition from an acute phase with prominent peripheral neurogenic inflammation to a chronic phase with evident central nervous system changes. Ketamine is a centrally acting agent believed to work through blockade of N-methyl-d- aspartate receptors and is being increasingly used for the treatment of refractory CRPS, although the basis for the drug’s effects and efficacy at different stages of the syndrome remains unclear. Methods The authors used a mouse model of CRPS (n = 8 to 12/group) involving tibia fracture/cast immobilization to test the efficacy of ketamine (2 mg kg−1 day−1; 7 days) or vehicle infusion during acute (3 weeks after fracture) and chronic (7 weeks after fracture) stages. Results Acute-phase fracture mice displayed increased limb temperature, edema, and nociceptive sensitization that were not reduced by ketamine. Fracture mice treated with ketamine during the chronic phase showed reduced nociceptive sensitization that persisted beyond completion of the infusion. During this chronic phase, ketamine also reduced latent nociceptive sensitization and improved motor function at 18 weeks after fracture. No side effects of the infusions were identified. These behavioral changes were associated with altered spinal astrocyte activation and expression of pain-related proteins including N-methyl-d-aspartate receptor 2b, Ca2+/calmodulin-dependent protein kinase II, and brain-derived neurotrophic factor. Conclusions Collectively, these results demonstrate that ketamine is efficacious in the chronic, but not acute, stage of CRPS, suggesting that the centrally acting drug is relatively ineffective in early CRPS when peripheral mechanisms are more critical for supporting nociceptive sensitization.

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Plasma Metabolome Normalization in Rheumatoid Arthritis Following Initiation of Methotrexate and the Identification of Metabolic Biomarkers of Efficacy

Metabolites ◽

10.3390/metabo11120824 ◽

2021 ◽

Vol 11 (12) ◽

pp. 824

Author(s):

Matthew R. Medcalf ◽

Pooja Bhadbhade ◽

Ted R. Mikuls ◽

James R. O’Dell ◽

Rebekah L. Gundry ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Enrichment Analysis ◽

Additional Measure ◽

Das 28 ◽

Plasma Metabolome ◽

Before And After ◽

Healthy Control ◽

Clinically Significant ◽

Metabolic Basis ◽

Metabolic Biomarkers

Methotrexate (MTX) efficacy in the treatment of rheumatoid arthritis (RA) is variable and unpredictable, resulting in a need to identify biomarkers to guide drug therapy. This study evaluates changes in the plasma metabolome associated with response to MTX in RA with the goal of understanding the metabolic basis for MTX efficacy towards the identification of potential metabolic biomarkers of MTX response. Plasma samples were collected from healthy control subjects (n = 20), and RA patients initiating MTX therapy (n = 20, 15 mg/week) before and after 16 weeks of treatment. The samples were analyzed by a semi-targeted metabolomic analysis, and then analyzed by univariate and multivariate methods, as well as an enrichment analysis. An MTX response was defined as a clinically significant reduction in the disease activity score in 28 joints (DAS-28) of greater than 1.2; achievement of clinical remission, defined as a DAS-28 < 2.6, was also utilized as an additional measure of response. In this study, RA is associated with an altered plasma metabolome that is normalized following initiation of MTX therapy. Metabolite classes found to be altered in RA and corrected by MTX therapy were diverse and included triglycerides (p = 1.1 × 10−16), fatty acids (p = 8.0 × 10−12), and ceramides (p = 9.8 × 10−13). Stratification based on responses to MTX identified various metabolites differentially impacted in responders and non-responders including glucosylceramides (GlcCer), phosphatidylcholines (PC), sphingomyelins (SM), phosphatidylethanolamines (PE), choline, inosine, hypoxanthine, guanosine, nicotinamide, and itaconic acid (p < 0.05). In conclusion, RA is associated with significant alterations to the plasma metabolome displaying at least partial normalization following 16 weeks of MTX therapy. Changes in multiple metabolites were found to be associated with MTX efficacy, including metabolites involved in fatty acid/lipid, nucleotide, and energy metabolism.

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Effect of Ramadan fasting on disease activity in patients with rheumatoid arthritis presenting in tertiary care hospital

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.36.5.2099 ◽

2020 ◽

Vol 36 (5) ◽

Cited By ~ 1

Author(s):

Samara Siddique ◽

M. Yaser Imran ◽

Muhammad Naeem Afzal ◽

Uzma Malik

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Inflammatory Disorder ◽

Care Hospital ◽

Ramadan Fasting ◽

Creative Commons ◽

Das 28 ◽

Before And After

Background and objective: Rheumatoid Arthritis (RA) is a common inflammatory disorder affected by various factors, including fasting. The objective of the study was to establish the effect of Ramadan fasting on DAS 28 in Rheumatoid Arthritis patients. Methods: In this observational cohort study done in department of rheumatology, Mayo hospital, Lahore, between May 2019 to July 2019, 240 patients were divided in fasting (n=120) and non-fasting cohort (n=120) based on their own choice. Mean DAS-28 scores before and after Ramadan was compared in both cohorts with appropriate statistical analyses. Results: Two hundred forty participants, (74 males, 166 females), were recruited. Baseline DAS of fasting group was significantly low (4.35±0.9) as compared to non-fasting group (5.07±0.91). Paired t-test showed statistically significant improvement in fasting and non-fasting groups in total and in both genders (p=0.000). Mean improvement in DAS was numerically greater and statistically significant (p=0.000) in non-fasting group (1.08±0.62) as compared to fasting ones (0.86±0.61). Post-Ramadan DAS was, however, significantly low in fasting group (3.49±0.9) versus non-fasting group (3.98±1.0) (p=0.000). Conclusion: DAS 28 score decreased in both non-fasting as well as fasting patients of RA during the month of Ramadan. RA patients with moderate disease activity, who want to keep fast, can be allowed to do so without any fear of disease worsening. doi: https://doi.org/10.12669/pjms.36.5.2099 How to cite this:Siddique S, Imran Y, Afzal MN, Malik U. Effect of Ramadan fasting on disease activity in patients with rheumatoid arthritis presenting in tertiary care hospital. Pak J Med Sci. 2020;36(5):---------. doi: https://doi.org/10.12669/pjms.36.5.2099 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Influence of balneophysical therapy on activity, functional capacity, and quality of life in patients with rheumatoid arthritis

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0904171s ◽

2009 ◽

Vol 137 (3-4) ◽

pp. 171-174 ◽

Cited By ~ 5

Author(s):

Sonja Stojanovic ◽

Aleksandar Dimic ◽

Bojana Stamenkovic ◽

Aleksandra Stankovic ◽

Jovan Nedovic

Keyword(s):

Quality Of Life ◽

Rheumatoid Arthritis ◽

Disease Activity ◽

Functional Capacity ◽

Mean Value ◽

Disease Modifying Antirheumatic Drugs ◽

Das 28 ◽

Before And After ◽

The Mean

Introduction It has been well known that balneophysical therapy has a therapeutic effect on clinical and biological parameters of disease activity in the patients with rheumatoid arthritis (RA). Objective. To determine the influence of balneophysical therapy on functional capacity, activity and quality of life of the patients with RA primarily treated with some of disease modifying antirheumatic drugs. Methods. The study enrolled 73 patients with RA treated with some of disease modifying antirheumatic drugs (Methotrexate in 85% of patients). During hospitalization at the Clinical Rheumatologic Department of the Institute 'Niska Banja', the patients were treated, beside the medicamentous therapy, by hydrotherapy (oligomineral, homeothermic, low radioactive water), mineral peloid therapy, electrotherapy and kinesiotherapy. Before and after balneotherapy, the patients filled in the Health Assessment Questionnaire (HAQ) and the Quality of Life Rheumatoid Arthritis (QOL-RA) scale. The Disease Activity Score (DAS) 28 was used to measure the disease activity before and after balneotherapy. A possible value of HAQ was from 0 to 3, and QOL-RA from 0 to 10. Results. The mean value of the duration of balneophysical therapy was 14.7?4.8 days. We found significant improvement of functional capacity in the patients with RA. The average HAQ score before balneotherapy was 1.07?0.61, and 0.86?0.55 after balneotherapy, which was statistically significantly lower (p<0.05). DAS 28 after balneotherapy was also statistically significantly lower than DAS 28 before balneotherapy: the mean value of DAS 28 before therapy was 6.30?0.81 and after therapy 5.48?0.75 (p<0.001). The quality of life significantly improved after balneophysical therapy: the mean value of QOL-RA scale before therapy was 5.38?1.62 and after therapy 7.35?1.81 (p<0.05). Conclusion. Balneophysical therapy, when properly dosed, is an effective, adjuvant therapy in the patients with RA of mild disease activity. Balneophysical therapy has a positive influence on disease activity, functional capacity and quality of life in the patients with rheumatoid arthritis.

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Impact of east Japan earthquake disaster with massive tsunami for prevalence of Takotsubo syndrome – a multicenter regional registry before and after east Japan earthquake disaster

European Heart Journal ◽

10.1093/ehjci/ehaa946.1813 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

T Itoh ◽

N Toda ◽

T Osaki ◽

Y Maegawa ◽

R Yoshizawa ◽

...

Keyword(s):

Acute Phase ◽

Chronic Phase ◽

Takotsubo Syndrome ◽

Earthquake Disaster ◽

Coronary Syndrome ◽

Before And After ◽

Standard Incidence Ratio ◽

Long Term Prognosis ◽

Iwate Prefecture

Abstract Background Previous studies demonstrated Takotsubo syndrome (TS) was easy provoked by earthquake disaster. However, a previous other regional report demonstrated TS was not increased after 2011 east Japan earthquake disaster. The purpose of this study was to clarify incidence of TS after the earthquake disaster in Iwate prefecture during long term period. Method Consecutive hospitalized TS patients were registered during 8 years between 2009 and 2016 in our medical university and five Iwate prefecture hospitals. Moreover, patients were divided into two groups, i.e., those with the inland and those with tsunami-stricken area groups. Prevalence of TS were calculated by standard incidence ratio (SIR) before and after the earthquake disaster. Moreover, long-term prognosis in the both groups was compared using Kaplan-Meier analysis. Results A total of 112 TS (male 25 and female 87) were registered from acute coronary syndrome registry in each hospital (n=4,163). Averaged age was 75.3 year-old. A total number of TS just after the two months of the earthquake (March and April 2011) was nine and significance monthly variation was observed comparing with the other months (p=0.029). SIR before and after the disaster is as following Figure. There were no significant differences for long-term prognosis between the two groups (p=0.20). Conclusion Incidence of TS was increased in acute phase after east Japan earthquake disaster. However, significance increases were maintained during long-term period, although number of TS was decreased after acute phase. TS is increased not only acute but also chronic phase after the serious earthquake disaster. Standard incidence ratio Funding Acknowledgement Type of funding source: None

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Abstract TP95: Novel Biomarkers of Acute Ischemic Stroke Using MicroRNA Analysis

Stroke ◽

10.1161/str.51.suppl_1.tp95 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Jason King ◽

Evgeny Sidorov ◽

Jairam Vanamala ◽

Cynthia Bejar ◽

Vijay Indukuri ◽

...

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Acute Phase ◽

Chronic Phase ◽

Rna Isolation ◽

Acute Stage ◽

Stroke Recovery ◽

Stroke Severity ◽

Mirna Regulation ◽

Case Control Studies

Background: Despite recent advances in treatment, early diagnosis and prognosis of acute ischemic stroke (AIS) suffers from significant limitations. Growing number of mostly case-control studies have determined that noncoding, micro-ribonucleic acid (miRNAs) play a role in the pathophysiologic processes related to cerebral ischemia and post-stroke recovery. This pilot project is a longitudinal study, which investigates difference in miRNA regulation in acute vs. chronic stage of ischemic stroke. Hypothesis: Expression of some miRNAs is significantly altered in acute stage of ischemic stroke. Methods: Blood and urine specimens collected during the acute phase (<72 hours) of ischemic stroke and at follow-up phases (within 3 months) were used to quantify the expression of five selected miRNAs (miRNA 21-5p; miRNA 124-5p, miRNA 126, miRNA 223, and miRNA 298) using 20 sample pairs (N=40) available with urine and blood specimens. Total RNA from frozen blood samples were isolated using the mir VANA RNA isolation kit (Ambion, USA). We extracted exosomal RNA from urine samples using exosome kit (Qiagen, USA). We ran miRNA expression assays using TaqMan probes (Applied Biosciences, USA) on 384-well microplates using QuantStudio 6 available in our lab. Each assay was run in duplicates using endogenous (U6) and blank controls. Results: The miRNA21-5p was significantly down-regulated (p<0.0001) at the acute phase in both blood and urine; inversely, miRNA124 was significantly upregulated (p<0.0001) at the acute phase vs. the chronic phase. The increased expression of miRNA 124-5p in both urine and serum strongly correlated with a lower stroke scale (NIHSS score (<8)), and its expression was significantly diminished with the increase in stroke severity (NIHSS >10). Expression of exosomal miRNA126 extracted from urine, was significantly upregulated (p<0.0001) during the acute phase, but remained unchanged at the acute and chronic phase (p=0.857) in serum. Conclusion: Our study showed the dysregulation of important miRNAs in acute stage of stroke. The upregulation of miRNA 124-5p in strokes with lower NIHSS may serve as early prognostic biomarker. Once replicated in larger scale studies, it will provide novel insights on understanding stroke pathophysiology.

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