Early Dynamics of P-selectin and Interleukin 6 Predicts Outcomes in Ischemic Stroke

Pusch, Gabriella; Debrabant, Birgit; Molnár, Tihamér; Fehér, Gergely; Papp, Viktória; Bánáti, Miklós; Kovács, Norbert; Szekeres, L.; Illés, Zsolt

doi:10.1016/j.jstrokecerebrovasdis.2015.05.005

Cited by 33 publications

(23 citation statements)

References 44 publications

(61 reference statements)

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“…Furthermore, specific challenges regarding biomarkers of central nervous tissue include the penetration of BBB and the lack of correlation between functional symptoms and volume (as opposed to location) of injured tissue. According to pathophysiological processes underlying IS, potential inflammatory biomarkers may be classified as released by: (i) astroglial activation and neuronal injury (Table 1) [146,147,148,149,150,151,152,153,154,155,156,157]; (ii) systemic inflammatory response (Table 2) [158,159,160,161,162,163,164,165,166,167,168,169,170,171,172,173,174,175,176,177,178,179]; (iii) dysfunctional endothelium (Table 3) [180,181,182,183,184,185,186] (Figure 4). …”

Section: Inflammatory Mediators As Potential Diagnostic or Prognosmentioning

confidence: 99%

“…However, a recent meta-analysis pooling 24 longitudinal studies emphasized the low prognostic accuracy of IL-6 [171]. Interestingly, IL-6 has also been shown to predict the occurrence of infection in patients suffering from an IS [172,174]. Conversely, the anti-inflammatory cytokine IL-10 showed a different time course, characterized by a delayed increase over 72 h post-IS [198].…”

Section: Inflammatory Mediators As Potential Diagnostic or Prognosmentioning

confidence: 99%

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Update on Inflammatory Biomarkers and Treatments in Ischemic Stroke

Bonaventura

Liberale

Vecchiè

et al. 2016

IJMS

125

100

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After an acute ischemic stroke (AIS), inflammatory processes are able to concomitantly induce both beneficial and detrimental effects. In this narrative review, we updated evidence on the inflammatory pathways and mediators that are investigated as promising therapeutic targets. We searched for papers on PubMed and MEDLINE up to August 2016. The terms searched alone or in combination were: ischemic stroke, inflammation, oxidative stress, ischemia reperfusion, innate immunity, adaptive immunity, autoimmunity. Inflammation in AIS is characterized by a storm of cytokines, chemokines, and Damage-Associated Molecular Patterns (DAMPs) released by several cells contributing to exacerbate the tissue injury both in the acute and reparative phases. Interestingly, many biomarkers have been studied, but none of these reflected the complexity of systemic immune response. Reperfusion therapies showed a good efficacy in the recovery after an AIS. New therapies appear promising both in pre-clinical and clinical studies, but still need more detailed studies to be translated in the ordinary clinical practice. In spite of clinical progresses, no beneficial long-term interventions targeting inflammation are currently available. Our knowledge about cells, biomarkers, and inflammatory markers is growing and is hoped to better evaluate the impact of new treatments, such as monoclonal antibodies and cell-based therapies.

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Section: Inflammatory Mediators As Potential Diagnostic or Prognosmentioning

confidence: 99%

Section: Inflammatory Mediators As Potential Diagnostic or Prognosmentioning

confidence: 99%

Update on Inflammatory Biomarkers and Treatments in Ischemic Stroke

Bonaventura

Liberale

Vecchiè

et al. 2016

IJMS

125

100

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“…This raises the demand for early prognostic parameters and criteria for patient selection even prior to MT [29][30][31][32] . In stroke, elevated levels of WBC counts are a known independent risk factor for an unfavorable outcome [7][8][9][10][11][12][13][14] . However, this topic has never been studied in the context of MT before.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, growing evidence suggests that early inflammatory markers like elevated WBC counts or IL-6 not only mirror the extent of ischemic inflammation but also correlate with the clinical course and patients' outcome [7][8][9][10][11][12][13][14] . Therapeutic strategies modulating the inflammatory response in stroke patients are being pursued for many years, raising the hope of positively influencing the inflammatory response in the future [15][16][17][18][19][20][21][22] .…”

Section: Introductionmentioning

confidence: 99%

Blood Leukocytes as Prognostic Parameter in Stroke Thrombectomy

Huber

Kleine²,

Kaesmacher³

et al. 2016

Cerebrovasc Dis

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Purpose: Despite the recent success of mechanical thrombectomy (MT) in the treatment of acute ischemic stroke, prognostic parameters and criteria for patient selection are yet uncertain. Elevated levels of white blood cells (WBCs) constitute an independent risk factor for unfavorable outcome. Here we studied the link between outcome and WBC counts obtained before and after successful MT. Methods: One hundred fifteen acute stroke patients successfully treated with MT (thrombolysis in cerebral infarction-scores 2b or 3) were included. WBC counts and C-reactive protein (CRP) levels were obtained prior to (WBC-pre, CRP-pre) and 1 day after MT (WBC-post, CRP-post). Clinical outcome measures consisted of National Institute of Health Stroke Scale (NIHSS) scores, and modified Rankin Scale (mRS) on day 90 (mRS-d90), dichotomized between scores ≤5 and >5 (NIHSS) and ≤2 and >2 (mRS). The association between WBC-/CRP-levels and outcome was assessed by correlation- and receiver-operating characteristic analyses. Results: WBC counts on day 1 after MT correlated significantly with NIHSS scores at discharge and mRS-d90. Among patients >50 years, no patient with WBC-post counts exceeding 14.2 G/l had favorable NIHSS scores (≤5), and no one with WBC-post counts ≥12.6 G/l had favorable mRS-d90 outcome-scores (≤2). Further, even WBC-pre counts ≥10.6 G/l predicted unfavorable mRS-d90-scores in this subgroup. Conclusion: Elevated WBC counts obtained in routine blood tests may constitute a simple and economic parameter to estimate outcome after successful MT. Moreover, present data suggest that in patients older than 50 years, WBC counts may help to predict outcome even when obtained prior to MT.

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“…Elevated concentration of IL-6 at 6 h and increased NIHSS score on admission were associated with early deterioration within 48 h or death. At 72 h from the ischemic infarct onset, IL-6 concentration correlated with the S100β protein levels and size of tissue damage [172]. The IL-6 serum levels changes could also be useful for evaluation of transient ischemic attack (TIA) and silent lacunar infarction.…”

Section: Interleukin-6mentioning

confidence: 99%

Neurovascular Unit as a Source of Ischemic Stroke Biomarkers—Limitations of Experimental Studies and Perspectives for Clinical Application

Steliga

Kowiański

Czuba

et al. 2019

Transl. Stroke Res.

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Cerebral stroke, which is one of the most frequent causes of mortality and leading cause of disability in developed countries, often leads to devastating and irreversible brain damage. Neurological and neuroradiological diagnosis of stroke, especially in its acute phase, is frequently uncertain or inconclusive. This results in difficulties in identification of patients with poor prognosis or being at high risk for complications. It also makes difficult identification of these stroke patients who could benefit from more aggressive therapies. In contrary to the cardiovascular disease, no single biomarker is available for the ischemic stroke, addressing the abovementioned issues. This justifies the need for identifying of effective diagnostic measures characterized by high specificity and sensitivity. One of the promising avenues in this area is studies on the panels of biomarkers characteristic for processes which occur in different types and phases of ischemic stroke and represent all morphological constituents of the brains' neurovascular unit (NVU). In this review, we present the current state of knowledge concerning already-used or potentially applicable biomarkers of the ischemic stroke. We also discuss the perspectives for identification of biomarkers representative for different types and phases of the ischemic stroke, as well as for different constituents of NVU, which concentration levels correlate with extent of brain damage and patients' neurological status. Finally, a critical analysis of perspectives on further improvement of the ischemic stroke diagnosis is presented.

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Early Dynamics of P-selectin and Interleukin 6 Predicts Outcomes in Ischemic Stroke

Cited by 33 publications

References 44 publications

Update on Inflammatory Biomarkers and Treatments in Ischemic Stroke

Update on Inflammatory Biomarkers and Treatments in Ischemic Stroke

Blood Leukocytes as Prognostic Parameter in Stroke Thrombectomy

Neurovascular Unit as a Source of Ischemic Stroke Biomarkers—Limitations of Experimental Studies and Perspectives for Clinical Application

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