Basal IL‐6 and S100b levels are associated with infarct volume

Abstract

Objectives The study of biomarkers related to the infarct volume of acute ischaemic stroke (AIS) is a valuable clinical strategy. We conducted a prospective study to evaluate the relationship between a wide panel of biomarkers involved in different biochemical pathways and lesion volume. Materials & Methods We studied 332 patients with AIS. Infarct volume was calculated from diffusion weighted imaging (DWI). Blood samples were drawn within 24 h of symptom onset to test a panel of biomarkers that included high‐sensitivity C‐reactive protein (hs‐CRP), IL‐6, neuron‐specific enolase (NSE), N‐terminal pro‐B‐type natriuretic peptide (NT‐ProBNP), S100b, troponin and IL‐10. Results The median lesion volume was 2.5 cc (IQR: 0.6–15.3). Patients with previous atrial fibrillation, cardioembolic aetiology and total anterior circulation infarct TACI classification had higher lesion volumes than those without them. Patients with previous recent TIA had smaller ischaemic lesions than those without it. Age and NIHSS were significantly correlated with lesion volume. In a linear regression analysis adjusted by aetiology, S100b and IL‐6 emerged as the only biomarkers independently associated with infarct volume. In contrast, previous recent TIA and small‐vessel disease were inversely related to infarct volume. Conclusions The correlation between the two blood marker levels and ischaemic lesion volume would support the use of these biomarkers as a surrogate endpoint in AIS, especially in centres without DWI 24/7 but these could not substitute basic neuroimaging. Our findings should be further explored in larger, preferably multicentre studies.

S100b in acute ischemic stroke clots is a biomarker for post-thrombectomy intracranial hemorrhages

“…We did not assess S100b levels in serum in this study. S100b serum levels are known to be higher in stroke cases with larger lesion volumes ( 65 , 66 ). It would be of interest to assess if clot S100b content reflects serum levels in future work.…”

Fluid biomarkers in stroke: From animal models to clinical care

“…These results indicated a good correlation with infarct volume within the first week after AIS 127 . Purroy et al 128 combined NfL levels at 48 h with NIHSS at 24 h and improved the prediction of poor outcomes (mRS: 3 months ≥ 3). Chen et al 129 showed that higher NfL levels before, immediately after, and 24 h after MT were associated with unfavourable outcomes.…”

“…IL‐6 is an inflammatory cytokine with a wide variety of biological functions and has been independently associated with infarct volume 24 h after symptom onset in a study with 332 IS patients. Higher IL‐6 levels might also be related to higher rates of unsuccessful recanalization due to an imbalance toward a proinflammatory and procoagulant state 128,137 …”

“…Higher IL-6 levels might also be related to higher rates of unsuccessful recanalization due to an imbalance toward a proinflammatory and procoagulant state. 128,137 Plasma C-reactive protein (CRP) has different roles associated with host defence. Elevated CRP level was related to poor functional outcome (mRS ≥ 3), as well as with high mortality at 3 months.…”

Immediate outcome prognostic value of plasma factors in patients with acute ischemic stroke after intravenous thrombolytic treatment

“…In human studies, the serum level of IL-6 is significantly correlated with infarct size and survival in stroke [ 14 , 15 ]. Francisco et al [ 16 ] demonstrated that IL-6 emerged as the only biomarker independently associated with infarct volume in AIS patients. Similarly, in our study, the levels of IL-6 were increased in AIS patients with NIHSS scores greater than 5.…”