Serum CXCL12 Levels as a Novel Predictor of Future Stroke Recurrence in Patients with Acute Ischemic Stroke

Abstract

Previous studies had shown that CXC chemokine ligand-12 (CXCL12) plays a significant role in animal models of ischemic stroke, but its role in human stroke is unclear. The aim of this study was to test the relationship between elevated serum circulating CXCL12 levels and the 1-year stroke recurrence in Chinese patients with acute ischemic stroke (AIS). All consecutive patients with first-ever acute ischemic stroke from January 2011 to September 2013 were recruited to participate in the study. Serum levels of CXCL12 and National Institute of Health Stroke Scale (NIHSS) were measured at the time of admission. Logistic regression analysis was used to evaluate the stroke recurrence according to serum CXCL12 levels. Receiver operating characteristic (ROC) curve was used to evaluate the accuracy of serum CXCL12 in predicting stroke recurrence. Clinical follow-up was performed at 1 year. In our study, 248 patients finished the 1-year follow-up. At 1-year follow-up, 31 patients had a recurrence ischemic stroke. The median CXCL12 levels were significantly higher in those who sustained a recurrence ischemic stroke compared with those who did not [24.2 ng/mL (IQR 15.4-33.7) vs 6.5 ng/mL (IQR 3.4-10.2); Z = 8.258, P < 0.0001]. In multivariate analysis, there was an increased risk of stroke recurrence associated with serum CXCL12 levels ≥12.15 ng/mL (OR 9.122, 95 % CI 6.103-15.104) after adjusting for above possible confounders. The time to recurrence stroke distribution between patients with baseline CXCL12 levels ≥12.15 ng/mL and those with baseline CXCL12 levels <12.15 ng/mL were significantly different (P < 0.0001, log-rank test). Elevated circulating CXCL12 levels at admission are strongly associated with the future recurrence of ischemic stroke in Chinese patients with AIS. Further studies are warranted to confirm this association and define the role for CXCL12 as a novel predictor biomarker for stroke recurrence.

The diagnostic and prognostic value of serum CXCL12 levels in patients with ischemic stroke

“…However, the role of CXCL12 in patients with AIS had controversies [4,5,9,10]. Gu et al [11] reported that elevated circulating CXCL12 levels at admission are strongly associated with the future recurrence of ischemic stroke in Chinese patients with AIS and Schutt et al [4] found that plasma CXCL12 levels was a predictor of future stroke. In addition, Ruscher et al [12] concluded that immoderate excessive activation of the CXCL12 pathway after stroke contributes to depression of neurologic function after stroke, and Kim et al [13] found that there was a correlation between serum CXCL12 and favorable long-term outcome in patients with AIS.…”

Advances in CXCR7 Modulators

“…The mechanism of action for agonists or antagonists may be more related to CXCL12-mediated effects than CXCR7. CXCL12 levels are increased in most pathological conditions that CXCR7 is overexpressed in, including tumors [112,113], rheumatoid arthritis [34,114,115], stroke [116,117], multiple sclerosis [118], traumatic brain injury [119][120][121] and obesity [48]. An exception is that decreased blood levels of CXCL12 are observed in Alzheimer's disease [122].…”

A Nomogram for Predicting Patent Foramen Ovale-Related Stroke Recurrence

“…First, the elevated hsCRP is likely to be associated with stroke severity (brain tissue lesion size, neurological deficits, etc. ), which itself is associated with prognosis ( 24 , 25 ). This means that hsCRP is likely to be a marker only and is not involved in the mechanism that leads to stroke recurrence.…”