Serum interleukin‐33 as a novel marker for long‐term prognosis and recurrence in acute ischemic stroke patients

Abstract

Objectives Interleukin‐33, a newly identified member of interleukin‐1 family, had been confirmed to play a crucial role in regulating inflammatory responses in various disease. However, the exact role of interleukin‐33 in the disease process of acute ischemic stroke still remains unclear. This study aims to demonstrate the relationship between interleukin‐33 levels and long‐term functional outcome as well as ischemic stroke recurrence. Methods Three hundred and four first‐ever acute ischemic stroke patients were recruited and basic information and history of all subjects taken within 72 hr on admission. The functional outcome was estimated by Barthel index. The multivariate logistic regression was used to analyze the prognosis, while the Cox proportional hazard model was applied to assess the recurrence risk. Results Out of 304 subjects, 259 patients successfully completed scheduled two‐year follow‐up. We found that higher interleukin‐33 levels correlated positively with better prognosis as compared with those with lower interleukin‐33 levels who presented with poorer outcome (62.45 ± 20.50 ng/ml vs. 51.58 ± 19.16 ng/ml, p < .001). After adjustment of all confounders, interleukin‐33 was associated with the one‐year prognosis with an adjusted odds ratio of 0.956 (95% confidence interval, 0.937–0.976, p < .001). Furthermore, interleukin‐33 levels were also closely related to recurrent ischemic stroke with an adjusted hazard ratio of 0.979 (95% confidence interval, 0.961–0.997, p = .025). Conclusions IL‐33 can be used to predict the long‐term outcomes and ischemic stroke recurrence in first‐ever acute ischemic stroke patients.

Potential microglia‐based interventions for stroke

“…Therefore, activated glial cellular signaling enhances the expression of M2 polarization markers on microglia and impairs the expression of M1 polarization markers after tMCAO. A clinical study of 259 stroke patients demonstrated that higher interleukin‐33 levels are positively correlated with better prognosis . However, this conclusion was inconsistent with the findings of another clinical study on 175 patients with aneurysmal subarachnoid hemorrhage (aSAH); this study reported that increases in the level of serum IL‐33 predict a worse prognosis of aSAH .…”

Resolution of inflammation and repair after ischemic brain injury

“…Higher serum IL-33 levels in acute ischemic stroke patients correlated positively with better prognosis, as compared with those with lower IL-33 levels. These patients presented with poorer outcome [85] suggesting that IL-33 is protective to stroke.…”

Serum Interleukin‐37 Increases in Patients after Ischemic Stroke and Is Associated with Stroke Recurrence

“…It is very attractive to find early serum markers to predict stroke recurrence. Different variables, such as IL-6 [43], IL-33 [44], VCAM-1 [15], CRP [45], vitamin D [46], and copeptin [47], had been proposed as useful biomarkers for predicting stroke recurrence events in patients with ischemic stroke. Similarly, we also found that CRP and IL-6 were independent predictor biomarkers for stroke recurrence.…”