<p>Effect of IL-6 and hsCRP Serum Levels on Functional Prognosis in Stroke Patients Undergoing IV-Thrombolysis: Retrospective Analysis</p>

Abstract

Purpose We evaluated the relationship between pretreatment IL-6 and hsCRP levels, symptom severity and functional outcome of patients with acute ischemic stroke (AIS) treated with IV-thrombolysis. Patients and Methods IL-6 and hsCRP samples were obtained from 83 consecutively treated Caucasian patients with AIS prior to initiation of IV-thrombolysis. Severity of stroke symptoms was assessed using the National Institutes of Health Stroke Scale (NIHSS), whereas functional outcome was assessed with modified Rankin Scale (mRS). The commercially available sets of enzymatic immune tests were used to estimate the concentrations of inflammatory markers in serum. Results Medians of IL-6 serum concentrations prior to IV-thrombolysis were lower in patients with favorable (mRS 0–2 pts) functional outcome than in those with unfavorable (mRS 3–6 pts) functional outcome, both at hospital dismission (5.92: 2.30–7.71 vs 9.46: 3.79–17.29 pg/mL; p <0.01) and on the ninetieth day from stroke onset (5.87: 2.30–10.58 vs 10.9: 5.94–17.28 pg/mL; p <0.01). There were no existing differences regarding hsCRP levels between groups (2.49: 0.11–9.82 vs 4.44: 0.32–9.87 mg/dL; p =0.30 and 2.57: 0.11–2.57 vs 2.83: 0.32–9.32 mg/dL; p =0.75, respectively). Patients with lacunar strokes were characterized by lower median of IL-6 (5.96: 2.87–13.0% vs 7.29: 2.30–17.28; p =<0.02) and hsCRP (2.25: 0.11–9.82 vs 4.84: 0.35–9.87; p =0.01) than those with nonlacunar infarctions. Multivariate analysis showed an impact of IL-6 on mRS measured on hospital dismission and after three months, regardless of their initial NIHSS, presence of hemorrhagic transformation and type 2 diabetes. No impact of hsCRP, lacunar etiology and patients’ age on functional outcome existed. Conclusion Regardless of the stroke etiology, pretreatment of IL-6, but not of hsCRP levels, may help to predict functional outcome after IV-thrombolysis independently of symptom severity and stroke complications.

Mediation effect of stroke recurrence in the association between post‐stroke interleukin‐6 and functional disability

“…Several previous studies have reported associations between IL‐6 and stroke recurrence 12–15 as well as associations between IL‐6 and functional disability independent of conventional risk factors among ischemic stroke patients 16–18 . Results from Mendelian randomization analyses provided evidence for a causal effect of IL‐6 signaling on ischemic stroke as well 29,30 .…”

Polygalasaponin F ameliorates middle cerebral artery occlusion-induced focal ischemia in rats through inhibiting TXNIP/NLRP3 signaling pathway

“…Anti-TNFα treatment signi cantly improves endothelial cell necrosis, attenuates disruption of the blood-brain barrier, and improves stroke outcome (Chen et al 2019). IL-6 is a pleiotropic cytokine that can be identi ed within 12-72 h of acute stroke onset and is a marker of in ammation in acute ischemic brain injury (Pawluk et al 2020).…”

Correlation of Serum IL-1β, IL-6, and hs-CRP levels with Infarct Core and Ischemic Penumbra Volume in Acute Ischemic Stroke

“…[17] Studies have also associated these in ammatory markers with increased mortality, recurrent vascular risk, and poor functional outcome. [15] They have been suggested to cause injury to vascular endothelial cells, promote the release of in ammatory factors, and activate the coagulation cascade that can lead to further expansion of the infarct core after stroke. [3,[20][21][22][23] The most studied in ammatory cytokines in AIS are the pro-in ammatory cytokines IL-1β, Il-6, and TNF-α.…”

“…Studies have also shown a signi cant increase in IL-6 concentration in the serum within a few hours of onset of ischemia, which lasts for up to 90 days after stroke. [11] Pawluk et al [15] suggested that IL-6 has potential prognostic signi cance for the success of thrombolytic therapy.…”