The role of inflammation in the development of post-stroke depression in elderly patients

2022 ◽  
pp. 841-847
Author(s):  
О.А. Осипова ◽  
Н.И. Клюшников ◽  
Е.В. Гостева ◽  
О.Н. Белоусова ◽  
Н.И. Жернакова ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Elderly Patients ◽  
Middle Age ◽  
The Elderly ◽  
Middle Aged ◽  
Post Stroke ◽  
Aged People ◽  
Tnf Α ◽  
Post Stroke Depression

Цель исследования - изучение роли цитокинов, соотношения нейтрофилов и лимфоцитов в развитии постинсультной депрессии (ПД) у больных пожилого возраста. В исследование были включены 110 больных с острым ишемическим инсультом, из них 60 человек среднего возраста (52±5 лет) и 50 - пожилого возраста (66±4 года). Контрольную группу составили 20 человек среднего возраста без инсульта в анамнезе. Через 3 мес наблюдения ПД в пожилом возрасте развилась у 28 (56 %) больных, в среднем возрасте - у 26 (43,3 %). Больные пожилого возраста с ишемическим инсультом, у которых развилась ПД, были достоверно старше (7,9 %, р<0,05), чаще имели артериальную гипертензию (12,4 %, р<0,05), уровень гликемии выше на 16,1 % (р<0,05), триглицеридов - на 14 % (р<0,05), ЛПНП - на 12,8 % (р<0,05). Больные среднего возраста с ПД имели ИМТ выше на 8,1 % (р<0,05), уровень гликемии - на 9,6 % (р<0,05), триглицеридов - на 10,9 % (р<0,05), ЛПНП - на 9,7 % (р<0,05), чем больные без депрессии. Пожилые больные с ишемическим инсультом и ПД имели более высокий уровень цитокинов - IL-1β был выше на 35,4 % (р<0,01), TNF-α - на 27 % (р<0,01), INF-γ - на 18 % (р<0,01), чем у больных без ПД. У больных пожилого возраста с ПД соотношение нейтрофилов и лимфоцитов (Н/Л) было на 46 % (p<0,001) выше, чем у больных без ПД. В группе больных пожилого возраста при наличии ПД соотношение Н/Л было на 50 % (p<0,001) выше, чем в аналогичной группе среднего возраста. Таким образом, у пожилых больных с ишемическим инсультом уровень маркеров воспаления может иметь прогностическое значение в развитии постинсультной депрессии. The aim of the study was to study the role of cytokines, the ratio of neutrophils and lymphocytes in the development of post-stroke depression in elderly patients. The study included 110 patients with acute ischemic stroke, including 60 middle-aged people (52±5 years) and 50 elderly people (66±4 years). The control group consisted of 20 middle-aged people without a history of stroke. After 3 months of follow-up, post-stroke depression (PSD) developed in the elderly in 28 patients (56 %), in the middle age in 26 patients (43,3 %). Patients with ischemic stroke in the elderly who developed PSD were significantly older (7,9 %, p<0,05), more often had arterial hypertension (12,4 %, p<0,05), the level of glucose was 16,1 % higher (p<0,05), triglycerides by 14 % (p<0,05), LDL-C by 12,8 % (p<0,05). In middle age, patients with post-stroke depression had a body mass index higher by 8,1 % (p<0,05), a glucose level by 9,6 % (p<0,05), triglycerides by 10,9 % (p<0,05), LDL-C by 9,7 % (p<0,05) than patients without PSD. Elderly patients with ischemic stroke and PSD had higher levels of cytokines - IL-1β was 35,4 % higher (p<0,01), TNF-α by 27 % (p<0,01), INF-γ by 18 % (p<0,01) than in patients without PSD. In elderly patients with PSD, the ratio of neutrophils and lymphocytes (N/L) is 46 % (p<0,001) higher than in patients without PSD. In the elderly, in the presence of PSD, the N/L ratio was 50 % (p<0,001) higher than in the same middle-aged group. Thus, in elderly patients with ischemic stroke, the level of inflammatory markers may have a prognostic value in the development of post-stroke depression.

Age-associated features of the development of fibrosis and inflamaging in patients with arterial hypertension and ischemic stroke

2022 ◽  
pp. 879-884
Author(s):  
О.А. Осипова ◽  
Е.В. Гостева ◽  
О.Н. Белоусова ◽  
Н.И. Жернакова ◽  
Н.И. Клюшников ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Elderly Patients ◽  
Arterial Hypertension ◽  
Old Age ◽  
Control Group ◽  
Cerebral Stroke ◽  
Middle Aged ◽  
Aged Patients ◽  
Tnf Α ◽  
Immune Inflammation

В статье рассмотрены вопросы развития фиброза и иммунного воспаления у больных артериальной гипертензией (АГ) с острым ишемическим инсультом (ИИ) в пожилом возрасте. Цель исследования - изучение возраст-ассоциированных особенностей концентрации маркеров фиброза (металлопротеиназы-9, тканевого ингибитора матриксных металлопротеиназ-1, их соотношения ММП-9/ТИМП-1), иммунного воспаления (TNF-α, IL-1β, INF-γ) у больных АГ с ИИ. В исследование были включены 86 больных АГ II степени, из которых 42 человека - среднего возраста (53±5 лет) и 44 - пожилого (66±5 лет), контрольную группу составили 22 пациента пожилого возраста с АГ без ИИ в анамнезе. Критерии включения - пациенты с АГ, поступившие в стационар в остром периоде первого церебрального инсульта. Установлено, что у пожилых больных АГ с ИИ показатели инфламэйджинга и маркеры фиброза были достоверно выше, чем у лиц среднего возраста. Уровень IL-1β был выше на 31,7 % (р<0,01), TNF-α - на 55,7 % (р<0,001), INF-γ - на 36,6 % (р<0,01), уровень ММП-9 - на 46,4 % (р<0,01), ТИМП-1 - на 21,2 % (р<0,01), ММП-9/ТИМП-1 - на 19,6 % (р<0,01) в пожилом возрасте по сравнению с больными среднего возраста с АГ и острым ИИ. Таким образом, установлено, что больные АГ с ИИ имеют нарушения процессов инфламейджинга, синтеза и деградации внеклеточного матрикса, особенно выраженные в пожилом возрасте. The article deals with the development of fibrosis and immune inflammation in patients with arterial hypertension and acute ischemic stroke in old age. The aim of the study was to study age-associated features of the concentration of fibrosis markers (metalloproteinase-9, tissue inhibitor of matrix metalloproteinases-1, their ratio MMP-9/TIMP-1), immune inflammation (TNF-α, IL-1β, INF-γ) in patients with arterial hypertension and ischemic stroke (AI). The study included 86 patients with arterial hypertension (AH) of the 2nd degree, of which 42 were middle-aged (53±5 years) and 44 elderly (66±5 years). The control group consisted of 22 elderly patients with AH without a history of AI. The criteria for inclusion in the study are patients with hypertension who were admitted to the hospital in the acute period of the first cerebral stroke. It was found that in elderly patients with hypertension with AI, the indicators of inflamaging and fibrosis markers were significantly higher than in middle-aged people. The level of IL-1β was 31,7 % higher (p<0,01), TNF-α by 55,7 % (p<0,001), INF-γ by 36,6 % (p<0,01), the level of MMP-9 was 46,4 % higher (p<0,01), TIMP-1 by 21,2 % (p<0,01), MMP-9/TIMP-1 by 19,6 % (p<0,01) in the elderly compared to middle-aged patients with hypertension and acute AI. Thus, it was found that patients with arterial hypertension and ischemic stroke have violations of the processes of inflamaging, synthesis and degradation of the extracellular matrix, especially pronounced in old age.

scholarly journals Aging as a Risk Factor on the Immunoexpression of Pro-Inflammatory IL-1β, IL-6 and TNF-α Cytokines in Chronic Apical Periodontitis Lesions

Biology ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 14
Author(s):  
Quésia Euclides Teixeira ◽  
Dennis de Carvalho Ferreira ◽  
Alexandre Marques Paes da Silva ◽  
Lucio Souza Gonçalves ◽  
Fabio Ramoa Pires ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Inflammatory Cytokines ◽  
Inflammatory Responses ◽  
The Elderly ◽  
Apical Periodontitis ◽  
Middle Aged ◽  
Tnf Α ◽  
Significant Difference ◽  
Cytokine Levels ◽  
Pro Inflammatory Cytokines

Persistent inflammatory responses in the elderly may act as modifiers on the progression and repair of chronic apical periodontitis lesions (CAPLs). While the involvement of IL-1β, IL-6 and TNF-α in inflammatory responses and, particularly, in CAPL has been documented, their expression in elderly patients needs to be further characterized. Therefore, the purpose of this study was to evaluate and compare the expressions of pro-inflammatory cytokines in CAPL from elderly individuals with young/middle-aged individuals. Thirty CAPL (15 cysts and 15 granulomas) from elderly patients (>60 years) and 30 CAPL (15 cysts and 15 granuloma) from young/middle-aged individuals (20–56 years) were selected. Immunohistochemical reactions were performed against IL-1β, IL-6 and TNF-α. The slides were subdivided into five high-magnification fields and analyzed. The number of positive stains was evaluated for each antibody. There was no significant difference between the cytokines when the cysts and granuloma were compared in the two groups. In the young/middle-aged, only IL-1β showed a difference and was significantly higher in granulomas (p = 0.019). CAPL pro-inflammatory cytokine levels in the elderly were significantly higher than in young/middle-aged individuals (p < 0.05). The pro-inflammatory cytokines IL-1β, IL-6 and TNF-α were significantly higher in CAPL in the elderly compared with the young/middle-aged group. Further elaborate research studies/analyses to elucidate the reasons for and consequences of inflammation in the elderly are recommended.

Abstract 21: Sex Differences in Post-Stroke Depression in the Elderly

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Naomi Mayman ◽  
Stanley Tuhrim ◽  
Nathalie Jette ◽  
Mandip S Dhamoon ◽  
Laura K Stein
Keyword(s):  
Sex Differences ◽  
Ischemic Stroke ◽  
Time Course ◽  
Cox Regression ◽  
Cumulative Risk ◽  
The Elderly ◽  
Stroke Patients ◽  
Post Stroke ◽  
Post Stroke Depression

Introduction: Post-stroke depression (PSD) occurs in approximately one-third of ischemic stroke patients. However, there is conflicting evidence on sex differences in PSD. Objective: We sought to assess sex differences in risk and time course of PSD in US ischemic stroke (IS) patients. We hypothesized that women are at greater risk of PSD than men, and that a greater proportion of women experience PSD in the acute post-stroke phase. Methods: Retrospective cohort study of 100% de-identified data for US Medicare beneficiaries ≥65 years admitted for ischemic stroke from July 1, 2016 to December 31, 2017. We calculated Kaplan-Meier unadjusted cumulative risk of depression, stratified by sex, up to 1.5 years following index admission. We performed Cox regression to report the hazard ratio (HR) for diagnosis of depression up to 1.5 years post-stroke in males vs. females, adjusting for patient demographics, comorbidities, length of stay, and acute stroke interventions. Results: Female stroke patients (n=90,474) were 20% more likely to develop PSD than males (n=84,427) in adjusted models. Cumulative risk of depression was consistently elevated for females throughout 1.5 years of follow-up (0.2055 [95% CI 0.2013-0.2097] vs. 0.1690 [95% CI 0.1639-0.1741] (log-rank p<0.0001). HR for PSD in females vs. males remained significant in fully adjusted analysis at 1.20 (95% CI 1.17-1.23, p<0.0001). Conclusions: Over 1.5 years of follow-up, female stroke patients had significantly greater hazard of developing PSD, highlighting the need for long-term depression screening in this population and further investigation of underlying reasons for sex differences.

Risk and Predictors of Depression Following Acute Ischemic Stroke in the Elderly

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000011828
Author(s):  
Naomi Mayman ◽  
Laura Katherine Stein ◽  
John Erdman ◽  
Alana Kornspun ◽  
Stanley Tuhrim ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cox Regression ◽  
Cumulative Risk ◽  
The Elderly ◽  
Stroke Patients ◽  
Post Stroke ◽  
Medicare Data ◽  
Kaplan Meier ◽  
Post Stroke Depression ◽  
History Of

Objective:We sought to comprehensively evaluate predictors of PSD in the US and compare PSD to post-myocardial infarction (MI) depression, in order to determine whether ischemic stroke (IS) uniquely elevates risk of depression.Methods:This is a retrospective cohort study of 100% de-identified inpatient, outpatient, and subacute nursing Medicare data from 2016-2017 for US patients aged ≥65 years from July 1, 2016 to December 31, 2017. We calculated Kaplan-Meier unadjusted cumulative risk of depression up to 1.5 years following index admission. We performed Cox regression to report the hazard ratio for diagnosis of depression up to 1.5 years post-stroke vs. MI, and independent predictors of PSD, and controlled for patient demographics, comorbidities, length of stay and acute stroke interventions.Results:In fully adjusted models, stroke patients (n=174,901) were ∼50% more likely than MI patients (n=193,418) to develop depression during the 1.5-year follow-up period (Kaplan-Meier cumulative risk 0.1596±0.001 in stroke patients versus 0.0973±0.000778 in MI patients, log-rank p<0.0001). History of anxiety was the strongest predictor of PSD, while discharge home was most protective. Female patients, White patients, and patients younger than 75 years were more likely to be diagnosed with depression post-stroke.Conclusions:Despite the similarities between MI and stroke, patients who suffer from stroke were significantly more likely to develop depression. There were several predictors of post-stroke depression, most significantly history of anxiety. Our findings lend credibility to a stroke-specific process causing depression and highlight the need for consistent depression screening in all stroke patients.

Complex treatment of periodontitis: patient’s reaction to the therapy

2020 ◽  
Vol 25 (2) ◽  
pp. 97-100
Author(s):  
A. K. Iordanishvili ◽  
V. A. Guk ◽  
A. A. Golovko
Keyword(s):  
Elderly People ◽  
Periodontal Diseases ◽  
Personal Characteristics ◽  
The Elderly ◽  
Comprehensive Treatment ◽  
Complex Treatment ◽  
Middle Aged ◽  
Aged People ◽  
Dental Rehabilitation ◽  
Success Of Treatment

Relevance. The success of treatment of periodontal diseases directly depends on the patient’s response to the therapy, therefore, the characteristics of the person’s personal characteristics can affect both the effectiveness of treatment and the prevention of relapse of the disease.Purpose. To study the features of the internal picture of the disease in the process of complex treatment of adult patients suffering from chronic generalized periodontitis.Materials and methods. The generally accepted comprehensive treatment of chronic generalized periodontitis in 69 middle-aged and elderly men was carried out taking into account the personal response of patients Solovyov «Psychosensory-anatomical-functional maladaptation syndrome».Results. When patients were discharged from the hospital, there was a difference in the phenomena of maladaptation among the elderly and middle-aged: in middle-aged people, sufficient adaptation to the conditions of existence was determined; in elderly people, due to the existing comorbid pathology, a state of maladaptation was diagnosed, which was caused by the presence of complaints of defects in the dentition.Conclusion. In elderly people, as soon as possible after completion of treatment in a hospital, dental rehabilitation cannot be considered completed, which requires the adoption of organizational measures for their timely provision of dentures.

Oxidative Stress and Post-Stroke Depression: Possible Therapeutic Role of Polyphenols?

2014 ◽  
Vol 22 (3) ◽  
pp. 343-351 ◽  
Author(s):  
Seyed Nabavi ◽  
Olivia Dean ◽  
Alyna Turner ◽  
Antoni Sureda ◽  
Maria Daglia ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Therapeutic Role ◽  
Post Stroke ◽  
Post Stroke Depression

Red Blood Cell Indices in Relation to Post-stroke Psychiatric Disorders: A Longitudinal Study in a Follow-up Stroke Clinic

2020 ◽  
Vol 17 (3) ◽  
pp. 218-223
Author(s):  
Haichao Wang ◽  
Li Gong ◽  
Xiaomei Xia ◽  
Qiong Dong ◽  
Aiping Jin ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Ischemic Stroke ◽  
Blood Cell ◽  
Cox Regression ◽  
Depression And Anxiety ◽  
Cox Regression Analysis ◽  
Post Stroke ◽  
Rbc Indices ◽  
Post Stroke Depression

Background: Depression and anxiety after stroke are common conditions that are likely to be neglected. Abnormal red blood cell (RBC) indices may be associated with neuropsychiatric disorders. However, the association of RBC indices with post-stroke depression (PSD) and poststroke anxiety (PSA) has not been sufficiently investigated. Methods: We aimed to investigate the trajectory of post-stroke depression and anxiety in our follow- up stroke clinic at 1, 3, and 6 months, and the association of RBC indices with these. One hundred and sixty-two patients with a new diagnosis of ischemic stroke were followed up at 1, 3, and 6 months, and underwent Patient Health Questionnaire-9 (PHQ-9) and the general anxiety disorder 7-item (GAD-7) questionnaire for evaluation of depression and anxiety, respectively. First, we used Kaplan-Meier analysis to investigate the accumulated incidences of post-stroke depression and post-stroke anxiety. Next, to explore the association of RBC indices with psychiatric disorders after an ischemic stroke attack, we adjusted for demographic and vascular risk factors using multivariate Cox regression analysis. Results: Of the 162 patients with new-onset of ischemic stroke, we found the accumulated incidence rates of PSD (1.2%, 17.9%, and 35.8%) and PSA (1.2%, 13.6%, and 15.4%) at 1, 3, and 6 months, respectively. The incident PSD and PSA increased 3 months after a stroke attack. Multivariate Cox regression analysis indicated independent positive associations between PSD risk and higher mean corpuscular volume (MCV) (OR=1.42, 95% CI=1.16-1.76), older age (OR=2.63, 95% CI=1.16-5.93), and a negative relationship between male sex (OR=0.95, 95% CI=0.91-0.99) and PSA. Conclusion: The risks of PSD and PSA increased substantially 3 months beyond stroke onset. Of the RBC indices, higher MCV, showed an independent positive association with PSD.

scholarly journals Isovitexin modulates autophagy in Alzheimer’s disease via miR-107 signalling

2020 ◽  
Vol 11 (1) ◽  
pp. 391-401
Author(s):  
Jiang Cheng ◽  
Guowei Wang ◽  
Na Zhang ◽  
Fang Li ◽  
Lina Shi ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Memory Loss ◽  
The Elderly ◽  
Tnf Α ◽  
Autophagic Process ◽  
Molecular Signals ◽  
Ad Mouse Model ◽  
Mtor Signalling

AbstractBackground:Alzheimer’s disease (AD) is an ultimately fatal, degenerative brain disease in the elderly people. In the current work, we assessed the defensive capability of isovitexin (IVX) through an intracerebroventricular injection of streptozotocin (STZ)-induced AD mouse model.Methods:Mice were separated into four cohorts: sham-operated control mice; STZ-intoxicated Alzheimer’s mice; IVX cohort, IVX + STZ; and Ant-107 cohort, antagomiR-107 + IVX/STZ as in the IVX cohort.Results:The outcomes indicated that IVX administration ameliorated spatial memory loss and blunted a cascade of neuro-noxious episodes – including increased amyloid-beta (Aβ) and degraded myelin basic protein burden, neuroinflammation (represented by elevated caspase-1, TNF-α and IL-6 levels) and autophagic dysfunction (represented by altered LC3-II, Atg7 and beclin-1 expressions) – via the inhibition of PI3K/Akt/mTOR signalling axis. We considered the question of whether the epigenetic role of microRNA-107 (miR-107) has any impact on these events, by using antagomiR-107.Conclusion:This probing underscored that miR-107 could be a pivotal regulatory button in the activation of molecular signals linked with the beneficial autophagic process and anti-inflammatory activities in relation to IVX treatment. Hence, this report exemplifies that IVX could guard against Aβ toxicity and serve as an effectual treatment for patients afflicted with AD.

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