Low triiodothyronine: A new facet of inflammation in acute ischemic stroke

Ma, Lili; Zhu, Dongliang; Jiang, Ying; Liu, Yingying; Ma, Xiaomeng; Liu, Mei; Chen, Xiaohong

doi:10.1016/j.cca.2016.04.023

Cited by 11 publications

(7 citation statements)

References 33 publications

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“…These changes may occur for various reasons, including damage to the hypothalamic-pituitary axis (HPA) following AIS, accumulation of proinflammatory cytokines as well as metabolic changes related to free fatty acid and bilirubin levels [31–33]. It was reported that the increased levels of IL-6 may lead to increased CRP as well as inhibition of the HPA, which subsequently depresses thyroid stimulation [34]. Thus, the acute stress following stroke may lead to the low FT3 levels versus low FT3 causing occurrence of stroke [5].…”

Section: Discussionmentioning

confidence: 99%

Low free triiodothyronineis predicts worsen neurological outcome of patients with acute ischemic stroke: a retrospective study with bioinformatics analysis

Zhang

Zhao

et al. 2019

BMC Neurol

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BackgroudPatients with acute ischemic stroke (AIS) often experience low serum free triiodothyronine (FT3), but the association of low FT3 with stroke severity, subtype and prognosis has not yet been thoroughly studied, and the molecular events underlying these clinical observation were also unclear.MethodsWe retrospectively collected 221 cases of AIS and 182 non-AIS cases with detailed clinical data from our department. FT3 concentrations were measured on admission to predict functional outcome within 3 months using multivariable models adjusted for other risk factors. Receiver operating characteristic (ROC) curves were calculated to define the best cutoff value of FT3 of stroke severity, subtypes and neurological outcome. Gene set enrichment, pathway mapping and network analyses of deferentially expressed genes (DEGs) were performed.ResultsFT3 was significantly decreased in AIS patients with National Institutes of Health Stroke Scale (NIHSS) > 3 and 3-months modified Rankin Scale (mRS) > 2. The cut-off value of FT3 for NIHSS on admission was 4.30 pmol/L. Also, FT3 level was significantly lower in large artery atherosclerosis (LAA) group and cardioembolism (CE) group than that in small vessel occlusion (SVO). FT3 value served as an independent predictor for neurological outcomes for which the cut-off value of FT3 was 4.38 pmol/l. Gene ontology (GO) analysis showed that the biological function of DEGs was mainly enriched in multicellur organism, neuron differentiation and cellular response to hypoxia. The cellular components were involved in extracelluar region, exosome and matrix, and the molecular functions were transcriptional activator activity, DNA binding and nuclear hormone receptor binding. Signal pathways analysis was indicative of neuroactive ligand-receptor interaction, thyroid hormone signaling pathway, and protein digestion and absorption these DEGs were involved in. Six related gene were identified as hubs from the protein-protein interaction (PPI) networks. Three modules were selected from PPI, of which MMP4, ADRA2C and EIF3E were recognized as the seed genes.ConclusionsLow FT3 value on admission was associated with stroke severity, subtype and prognosis. In addition, DEGs identified from bioinformatics analysis are likely to be candidates for elucidating clinical outcomes with low FT3, and provide us with therapeutic targets for improving stroke prognosis.

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Section: Discussionmentioning

confidence: 99%

Low free triiodothyronineis predicts worsen neurological outcome of patients with acute ischemic stroke: a retrospective study with bioinformatics analysis

Zhang

Zhao

et al. 2019

BMC Neurol

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“…Most of studies have focused on the role of free triiodothyronine (T3) in those conditions. It has been shown that low levels of this hormone (low fT3 syndrome) are predictor of poor outcome also in ischemic stroke [10,11]. Recently the association between thyroid stimulating hormone and stroke prognosis has been reported [12].…”

Section: Introductionmentioning

confidence: 99%

Predictive value of serum transthyretin for outcome in acute ischemic stroke

et al. 2017

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IntroductionThe impact of choroid plexus with its blood–cerebrospinal fluid barrier in the ischemic stroke pathology is poorly explored. Transthyretin (TTR) is a protein synthesized in liver and just in choroid plexus.ObjectivesThe current study was designed to assess the prognostic value of serum TTR for functional outcome (at the time of hospital discharge) and long-term (one-year) overall mortality in ischemic stroke patients.Patients and methodsWe conducted a prospective observational study. Patients (n = 81) with acute (< 24 hours of symptoms onset) ischemic stroke consecutively admitted to Stroke Unit were included. An unfavorable outcome was defined as a modified Rankin Scale (mRS) score ≥ 3. The relationships between serum TTR levels and clinical outcome were analyzed using multivariate analysis. One-year mortality was analyzed by Kaplan–Meier survival curves stratified by mean value of TTR.ResultsCompared with patients with mRS <3, patients with an unfavorable outcome at hospital discharge had significantly lower TTR levels on admission (P < 0.0001). In non-survivals serum TTR levels were significantly lower compared with patients who survive one year of observation (P = 0.009). Using multivariate analysis, transthyretin emerged as an independent predictor for unfavorable outcome at the day of hospital discharge (adjusted odds ratio = 0.96; 95% CI: 0.9–0.99, P <0.05). A one-year mortality of patients with the lower TTR levels was significantly higher than in patients with TTR levels above mean value (P = 0.02).ConclusionsSerum level of TTR at admission was a predictor of functional outcome after ischemic stroke and was also associated with one-year mortality in stroke survivals.

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“…Ma found that fT3 negatively correlates to CRP and the NIHSS and positively correlates to albumin concentrations. They postulate that fT3 might be involved in the inflammatory process following a stroke and might be able to predict stroke severity [43]. This could suggest that fT3 is linked to other inflammatory biomarkers, but is not an independent biomarker by itself.…”

Section: Discussionmentioning

confidence: 99%