The value of leukocyte adhesion molecules in patients after ischemic stroke

Abstract

Leukocyte recruitment and inflammatory response play an important patho-physiologic role after cerebral ischemia. This study aimed to evaluate whether leukocyte adhesion molecules can predict clinical outcome in patients after ischemic stroke. We prospectively examined serial changes in p-selectin glycoprotein ligand-1 (PSGL-1), macrophage antigen-1 (Mac-1), and lymphocyte function-associated antigen-1 (LFA-1) expression by leukocyte subsets using flow cytometry at various time points in 65 acute ischemic stroke patients and 60 controls. PSGL-1 expression on neutrophils and monocytes was significantly higher from day 1 to 90 after stroke as compared with control subjects (p < 0.05). The expression of monocyte Mac-1, LFA-1, and neutrophil Mac-1 were also significantly increased on days 1 and 7 after stroke than in control subjects (p < 0.05). Neutrophil PSGL-1 expression on day 1 was significantly higher in patients with early neurologic deterioration (END) (p < 0.01). Monocyte Mac-1 expression positively correlated with National Institutes of Health Stroke Scale (NIHSS) scores on admission (p = 0.013, gamma = 0.318). Underlying disease of diabetes mellitus and NIHSS score on admission were independently associated with 3-month outcome. The expressions of leukocyte adhesion molecules on admission are significantly increased in patients with acute ischemic stroke. This study shows that higher neutrophil PSGL-1 expression on admission may imply a higher risk for END and that monocyte Mac-1 expression on admission reflects the severity of ischemic stroke on admission.

Predictors of poor outcomes in First-Event Ischemic Stroke as assessed by Magnetic Resonance Imaging

“…In addition to NIHSS scores, there are several clinical risk factors that contribute to poor functional outcomes after ischemic stroke [8,[13][14][15][16][17][18][19]. The majority of the damage following acute ischemic stroke does not occur immediately, but rather develops gradually over the course of the following hours [20].…”

“…Stroke severity was assessed with the NIHSS. Early neurologic deterioration (END) was defined as an increase of four points in the NIHSS score between admission and any time during the first 48 hours of hospitalization [8]. The Outpatient Department followed most surviving patients after discharge, although some were interviewed by telephone, to identify neurological outcomes.…”

Structural Basis for Simvastatin Competitive Antagonism of Complement Receptor 3

“…CR3 is expressed in myeloid cells, notably neutrophil granulocytes and macrophage subsets, with major roles in leukocyte extravasation and phagocytosis (3). CR3 contributes to atherosclerosis (4), and the severity of acute ischemic stroke correlates with the level of CR3 expressed on monocytes (5). Inhibition of CR3 expressed in microglial cells limits synaptic loss in animal models of Alzheimer disease (6).…”

Advances in cerebrovascular disease research in the last year

“…den Hertog et al [3] studied the relation between CRP values and poor outcome (mRS [ 2) or death at 3 months in 561 patients within 12 h of ischemic stroke onset that participated in the Paracetamol (Acetaminophen) In Stroke (PAIS) trial. Patients with CRP levels C7 mg/L more often had a poor outcome (57 vs. 42%; p = 0.006) or died (23 vs. 13%; p = 0.0007) than patients with lower CRP levels.…”

“…Tsai et al [2] evaluated the value of leukocyte adhesion molecules in 65 acute ischemic stroke patients and 60 controls, showing that the expression of leukocyte adhesion molecules on admission is significantly increased in patients with acute ischemic stroke. This prospective study found that higher neutrophil PSGL-1 expression on day 1 is associated with a higher risk for early neurologic deterioration (END) and that monocyte Mac-1 expression reflects the severity of ischemic stroke.…”