Is Stroke Etiology a Determining Factor for the Pattern of Secondary Immune Alterations?

Dressel, Alexander

doi:10.1159/000329528

Cited by 1 publication

(1 citation statement)

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“…Together with our previous report on cryptogenic and LVD stroke [26], these findings point to the need for future studies aiming at decifering the immune response to stroke to stratify the ischemic stroke patients not only according to stroke severity but also the importance of controling for stroke etiology [47]. As complement activation in the peripheral circulation is determined by the response to stroke as well as the underlying pathology, more studies on the role of the complement system in pathogenesis and outcome of ischemic stroke based on larger patient populations are warranted.…”

Section: Discussionsupporting

confidence: 57%

Cardioembolic and Small Vessel Disease Stroke Show Differences in Associations between Systemic C3 Levels and Outcome

et al. 2013

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BackgroundActivation of the complement system has been proposed to play a role in the pathophysiology of stroke. As the specific involvement of the complement proteins may be influenced by stroke etiology, we compared plasma C3 and C3a levels in patients with cardioembolic (CE) and small vessel disease (SVD) subtypes of ischemic stroke and control subjects and evaluated their association to outcome at three months and two years.Methodology/Principal FindingsPlasma C3 and C3a levels in 79 CE and 79 SVD stroke patients, sampled within 10 days and at three months after stroke, and age- and sex-matched control subjects from The Sahlgrenska Academy Study on Ischemic Stroke were measured by ELISA. Functional outcome was assesed with modified Rankin Scale. In the CE group, plasma C3 levels were elevated only in the acute phase, whereas C3a was elevated at both time points. The follow-up phase plasma C3 levels in the upper third were associated with an increased risk of unfavorable outcome at three months (OR 7.12, CI 1.72–29.46, P = 0.007) as well as after two years (OR 8.25, CI 1.61–42.28, P = 0.011) after stroke. These associations withstand adjustment for age and sex. Conversely, three-month follow-up plasma C3a/C3 level ratios in the middle third were associated with favorable outcome after two years both in the univariate analysis (OR 0.19, CI 0.05–0.82, P = 0.026) and after adjustment for age and sex (OR 0.19, CI 0.04–0.88, P = 0.033). In the SVD group, plasma C3 and C3a levels were elevated at both time points but showed no significant associations with outcome.ConclusionsPlasma C3 and C3a levels are elevated after CE and SVD stroke but show associations with outcome only in CE stroke.

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Section: Discussionsupporting

confidence: 57%