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Xu Y, Wang Q, Chen J, Ma Y, Liu X. Updating a Strategy for Histone Deacetylases and Its Inhibitors in the Potential Treatment of Cerebral Ischemic Stroke. DISEASE MARKERS 2020; 2020:8820803. [PMID: 32963637 PMCID: PMC7492879 DOI: 10.1155/2020/8820803] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 08/25/2020] [Accepted: 08/26/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Cerebral ischemic stroke is one of the severe diseases with a pathological condition that leads to nerve cell dysfunction with seldom available therapy options. Currently, there are few proven effective treatments available for improving cerebral ischemic stroke outcome. However, recently, there is increasing evidence that inhibition of histone deacetylase (HDAC) activity exerts a strong protective effect in in vivo and vitro models of ischemic stroke. Review Summary. HDAC is a posttranslational modification that is negatively regulated by histone acetyltransferase (HATS) and histone deacetylase. Based on function and DNA sequence similarity, histone deacetylases (HDACs) are organized into four different subclasses (I-IV). Modifications of histones play a crucial role in cerebral ischemic affair development after translation by modulating disrupted acetylation homeostasis. HDAC inhibitors (HDACi) mainly exert neuroprotective effects by enhancing histone and nonhistone acetylation levels and enhancing gene expression and protein modification functions. This article reviews HDAC and its inhibitors, hoping to find meaningful therapeutic targets. CONCLUSIONS HDAC may be a new biological target for cerebral ischemic stroke. Future drug development targeting HDAC may make it a potentially effective anticerebral ischemic stroke drug.
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Affiliation(s)
- Yuzhen Xu
- Department of Neurology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301 Middle Yanchang Road, Shanghai, China
| | - Qian Wang
- Department of Central Laboratory, Taian City Central Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong Province, China
| | - Jianxin Chen
- Department of Neurology, Jinan First People's Hospital, Shandong Traditional Chinese Medicine University, Jinan, Shandong Province, China
| | - Yihong Ma
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Xueyuan Liu
- Department of Neurology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No. 301 Middle Yanchang Road, Shanghai, China
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Abstract
Major lipids making effects on the occurrence of acute ischemic stroke (AIS) is well recognized, but their roles on stroke severity remain uncertain. To explore the exact roles of lipids playing on stroke severity and the possible mechanism, we conduct this observational study.Data was collected from patients with AIS from February 2008 to May 2012. The level of major lipids was compared among AIS groups with different severity and investigated the correlation. Also, the relationship existed between major lipids and bilirubin. Mechanism of major lipids playing on stroke severity was researched to determine if oxidative stress reflected by bilirubin.Lower triglyceride (TG) and higher high density lipoprotein cholesterol (HDL-C) were observed in severe stroke, and obvious correlation existed between TG and stroke severity or HDL-C and stroke severity. TG was associated negatively with direct bilirubin (DBIL) and total bilirubin (TBIL), and lower level of DBIL and TBIL were related to higher quartiles of TG. There was no obvious difference of DBIL and TBIL among the groups of quartiles of HDL-C. TG was the influence factor of stroke severity in severe stroke through multiple univariable logistic regression. But it was not the independent influence factor after multivariable logistic regression adjusted by DBIL or TBIL. However, HDL-C was the influence factor of stroke severity through both univariable and multivariable logistic regression.Lower TG or higher HDL-C predicted severer stroke. The effect of TG on stroke severity was mediated by bilirubin, not HDL-C.
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Affiliation(s)
- Zheng Li
- Department of Rehabilitation, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University
| | - Jiahui Zhang
- Department of Neurology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Yun Luo
- Department of Neurology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
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Wei Y, Ren X, Su X, Wang X, Hua Y, Chen Y, Shi R, Shao P, Lang H, Ni C. Predictors and Changes of Self-Perceived Burden Among Stroke Survivors: A 3-Month Follow-Up Study. Front Neurol 2020; 11:742. [PMID: 32849208 PMCID: PMC7396516 DOI: 10.3389/fneur.2020.00742] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 06/16/2020] [Indexed: 12/11/2022] Open
Abstract
Background and Purpose: Patients' self-perceived burden (SPB) is associated with distress, which has a potentially negative influence on disease rehabilitation and quality of life. Stroke represents a significant health and social burden. The aim of the study was to assess, compare, and identify predictors of SPB in stroke survivors during the first 3 months post-stroke. Methods: A prospective longitudinal study was used. Consecutive stroke inpatients were recruited from the neurology department of three general hospitals in Xi'an, China. Patients were surveyed using the Self-perceived Burden Scale (SPBS) on the fourth day of admission (Acute phase, Time 1, T1) and 1 month (Time 2, T2) and 3 months (Time 3, T3) post-stroke. Results: Considerable burden was experienced by 84.15-91.50% of patients in the first 3 months post-stroke. The mean score of physical burden was the highest. Over time, physical, emotional, and economic burden all declined. The following characteristics had significant association with increased patient SPB at T1, T2, and T3: age, self-evaluated economic pressure, comorbidity, and functional status (P < 0.01). Patients' knowledge about stroke was only significantly associated with SPB at T3 (P < 0.01). Conclusions: Patients experienced a high degree of SPB in the early stage after stroke. Addressing the characteristics and predicting factors as well as the development of a targeted intervention for SPB may improve survival and post-stroke disability.
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Affiliation(s)
- Yuanyuan Wei
- School of Nursing, The Fourth Military Medical University, Xi'an, China.,Leshan Retired Cadre Sanatorium, Sichuan Military Region, Leshan, China
| | - Xiaoran Ren
- Department of Nursing, Shaanxi Traditional Chinese Medicine Hospital, Xi'an, China
| | - Xiangni Su
- School of Nursing, The Fourth Military Medical University, Xi'an, China
| | - Xianni Wang
- Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - Yan Hua
- School of Nursing, The Fourth Military Medical University, Xi'an, China
| | - Yu Chen
- School of Nursing, The Fourth Military Medical University, Xi'an, China
| | - Ruijie Shi
- School of Nursing, The Fourth Military Medical University, Xi'an, China
| | - Pei Shao
- School of Nursing, The Fourth Military Medical University, Xi'an, China
| | - Hongjuan Lang
- School of Nursing, The Fourth Military Medical University, Xi'an, China
| | - Chunping Ni
- School of Nursing, The Fourth Military Medical University, Xi'an, China
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Zhu N, Shu H, Jiang W, Wang Y, Zhang S. Mean platelet volume and mean platelet volume/platelet count ratio in nonvalvular atrial fibrillation stroke and large artery atherosclerosis stroke. Medicine (Baltimore) 2020; 99:e21044. [PMID: 32664115 PMCID: PMC7360237 DOI: 10.1097/md.0000000000021044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 05/27/2020] [Accepted: 06/01/2020] [Indexed: 11/25/2022] Open
Abstract
Ischemic stroke subtypes such as patients with large artery atherosclerosis, cardioembolism, and embolic stroke of undetermined source were investigated. This study was performed aimed to determine mean platelet volume (MPV) and mean platelet volume/platelet count (MPV/Plt) ratio in nonvalvular atrial fibrillation (AF) stroke and large artery atherosclerosis (LAA) stroke.We conducted a retrospective study of consecutive patients for treatment of acute ischemic stroke at Ruian People's Hospital from March 2017 to October 2018. The patients with ischemic stroke caused by AF and LAA were recruited to this study. Ischemic stroke was confirmed by magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA), ischemic lesions on diffusion-weighted imaging were measured in terms of size, composition, and pattern. MPV and platelet count were examined and (MPV/Plt) ratio was calculated.Three hundred seventy one patients were enrolled composing of 177 (47.7%) nonvalvular AF and 194 (52.2%) with LAA. The MPV (11.3 ± 1.3 vs 10.8 ± 1.0, P < .001) and MPV/Plt ratio (0.066 ± 0.025 vs 0.055 ± 0.20, P < .001) were much higher in AF group than LAA group. Receiver-operating characteristic (ROC) analysis showed MPV (AUC: 0.624, confidence interval: 0.567-0.68, P < .001) and MPV/Plt (AUC: 0.657, confidence interval: 0.601-0.713, P < .001) predicted AF between the 2 groups. MPV/Plt ratio was negatively associated with lesion volume (r = -0.161, P = .033) in AF. The analyses of subtypes of composition of infarcts and infarct pattern showed that MPV/Plt ratio was almost higher in AF than LAA except for subcortical-only pattern. Multivariable regression analyses demonstrated National Institutes of Health Stroke Scale (NIHSS) score (r = 2.74; P < .001), LAD (r = -1.15; P = .025) and MPV/Plt ratio (r = -180.64; P = .021) were correlated with lesion volume.Our results indicated elevated MPV and MPV/Plt ratio for the identification of difference between AF and LAA in patients with ischemic stroke.
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Affiliation(s)
- Ning Zhu
- Department of Cardiology, The Wenzhou Third Clinical Institute Affiliated To Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou
| | - Hao Shu
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Ruian People's Hospital, Ruian, Zhejiang Province, P.R. China
| | - Wenbing Jiang
- Department of Cardiology, The Wenzhou Third Clinical Institute Affiliated To Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou
| | - Yi Wang
- Department of Cardiology, The Wenzhou Third Clinical Institute Affiliated To Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou
| | - Shunkai Zhang
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Ruian People's Hospital, Ruian, Zhejiang Province, P.R. China
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Hou Y, Zhang N, Hao J, Wang X, Wen Z, Luo D, Ning B, Fu W, Liu Y. Acupuncture plus rehabilitation for post-stroke depression: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e21078. [PMID: 32664126 PMCID: PMC7360238 DOI: 10.1097/md.0000000000021078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 06/03/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Post-stroke depression (PSD) is a common stroke complication that is characterized by hopelessness, anxiety, disordered sleep, and lowered responsiveness. Rehabilitation and acupuncture treatments are often combined to treat PSD; however, there has been no meta-analysis on their synergistic effect. Therefore, we aim to perform a systematic review and meta-analysis to estimate the effectiveness of acupuncture and rehabilitation in PSD treatment. METHODS We will search the following electronic databases: PubMed, the Cochrane Library, EMBASE, the China National Knowledge Infrastructure, the Chinese Biomedical Literature Database, China Science and Technology Journal Database, and Wan Fang databases. We will include studies published between the database initiation and May 2020. Two reviewers will separately conduct study selection, data extraction, and risk of bias assessment. Disputes will be settled by consulting a third reviewer. Review Manager Software 5.3 will be employed for this meta-analysis. RESULTS This systematic review will assess whether acupuncture combined with rehabilitation treatment is more effective than rehabilitation alone in the management of PSD. CONCLUSION This systematic review will provide evidence regarding the synergistic effect of acupuncture and rehabilitation treatment for PSD.
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Affiliation(s)
- Yonghui Hou
- The First Hospital of Shijiazhuang City, Shijiazhuang, Hebei
| | - Ning Zhang
- The First Hospital of Shijiazhuang City, Shijiazhuang, Hebei
| | - Jieming Hao
- Shijiazhuang Community Health Service Management Center, Shijiazhuang, Hebei
| | - Xiangzhi Wang
- The First Hospital of Shijiazhuang City, Shijiazhuang, Hebei
| | - Zehuai Wen
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong
- National Center for Design Measurement and Evaluation in Clinical Research, Guangzhou University of Chinese Medicine
| | - Ding Luo
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong
- Situ Ling Studio of Lingnan Acupuncture School
- Famous Doctor's Studio of Academician Shi Xuemin, Guangzhou
- Shenzhen Bao’an Research Center for Acupuncture and Moxibustion, Shenzhen, Guangdong, China
| | - Baile Ning
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong
- Situ Ling Studio of Lingnan Acupuncture School
- Famous Doctor's Studio of Academician Shi Xuemin, Guangzhou
- Shenzhen Bao’an Research Center for Acupuncture and Moxibustion, Shenzhen, Guangdong, China
| | - Wenbin Fu
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong
- Situ Ling Studio of Lingnan Acupuncture School
- Famous Doctor's Studio of Academician Shi Xuemin, Guangzhou
- Shenzhen Bao’an Research Center for Acupuncture and Moxibustion, Shenzhen, Guangdong, China
| | - Ying Liu
- The First Hospital of Shijiazhuang City, Shijiazhuang, Hebei
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56
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Zhuo Y, Wu J, Qu Y, Yu H, Huang X, Zee B, Lee J, Yang Z. Clinical risk factors associated with recurrence of ischemic stroke within two years: A cohort study. Medicine (Baltimore) 2020; 99:e20830. [PMID: 32590771 PMCID: PMC7328985 DOI: 10.1097/md.0000000000020830] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
To identify the clinical risk factors and investigate the efficacy of a classification model based on the identified factors for predicting 2-year recurrence after ischemic stroke.From June 2017 to January 2019, 358 patients with first-ever ischemic stroke were enrolled and followed up in Shenzhen Traditional Chinese Medicine Hospital. Demographic and clinical characteristics were recorded by trained medical staff. The outcome was defined as recurrence within 2 years. A multivariate logistic regression model with risk factors and their interaction effects was established and evaluated.The mean (standard deviation) age of the participants was 61.6 (12.1) years, and 101 (28.2%) of the 358 patients were female. The common comorbidities included hypertension (286 patients, 79.9%), diabetes (148 patients, 41.3%), and hyperlipidemia (149 patients, 41.6%). The 2-year recurrence rate was 30.7%. Of the 23 potential risk factors, 10 were significantly different between recurrent and non-recurrent subjects in the univariate analysis. A multivariate logistic regression model was developed based on 10 risk factors. The significant variables include diabetes mellitus, smoking status, peripheral artery disease, hypercoagulable state, depression, 24 h minimum systolic blood pressure, 24 h maximum diastolic blood pressure, age, family history of stroke, NIHSS score status. The area under the receiver operating characteristic curve (ROC) was 0.78 (95% confidence interval: 0.726-0.829) with a sensitivity of 0.61 and a specificity of 0.81, indicating a potential predictive ability.Ten risk factors were identified, and an effective classification model was built. This may aid clinicians in identifying high-risk patients who would benefit most from intensive follow-up and aggressive risk factor reduction.The clinical trial registration number: ChiCTR1800019647.
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Affiliation(s)
| | - Jiaman Wu
- Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University
| | - Yimin Qu
- Centre for Clinical Trials and Biostatistics Lab, CUHK Shenzhen Research Institute, Shenzhen, China
| | - Haibo Yu
- Shenzhen Traditional Chinese Medicine Hospital
| | | | - Benny Zee
- Centre for Clinical Trials and Biostatistics Lab, CUHK Shenzhen Research Institute, Shenzhen, China
- Division of Biostatistics, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR
| | - Jack Lee
- Centre for Clinical Trials and Biostatistics Lab, CUHK Shenzhen Research Institute, Shenzhen, China
- Division of Biostatistics, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR
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Relationship between Uric Acid Level and Severity of Acute Primary Cerebral Infarction: A Cross-Sectional Study. BIOMED RESEARCH INTERNATIONAL 2020; 2020:2310307. [PMID: 32685451 PMCID: PMC7330623 DOI: 10.1155/2020/2310307] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 04/29/2020] [Accepted: 05/26/2020] [Indexed: 12/20/2022]
Abstract
Numerous studies have shown that uric acid (UA) is associated with cerebrovascular disease, but whether UA is a protective factor or worsens the risk of developing cerebrovascular disease remains controversial. This study investigated the relationship between UA levels detected at admission and the severity of acute primary cerebral infarction. This cross-sectional study enrolled patients with acute primary cerebral infarction (N = 238, 157 men). We designated the levels of serum UA measured at the time of admission as the independent variable and the degree of neurological impairment at admission as the dependent variable. The National Institutes of Health Stroke Scale (NIHSS) was used to assess the extent of neurological dysfunction: NIHSS ≤ 5, minor stroke; NIHSS > 5, moderate to severe stroke. There was a statistically significant difference in UA levels between patients with mild cerebral infarctions (NIHSS ≤ 5) and those with moderate or severe cerebral infarctions (NIHSS > 5) (P < 0.0001). After adjusting for confounding factors, the serum UA level was found to be nonlinearly related to NIHSS, and the inflection point was 372 μmol/L. The extent of the influence and confidence interval was 0.99 (0.98, 0.99) on the left side of the inflection point and 1.00 (1.00, 1.01) on the right side. There was a nonlinear relationship between the UA level measured on admission and the degree of neurological impairment in patients with acute primary cerebral infarction. When UA was <372 μmol/L, it was negatively correlated with the degree of neurological impairment in patients with acute cerebral infarction, but when UA was ≥372 μmol/L, the protective effect of UA disappeared.
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58
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Li S, Lu Y, Ding D, Ma Z, Xing X, Hua X, Xu J. Fibroblast growth factor 2 contributes to the effect of salidroside on dendritic and synaptic plasticity after cerebral ischemia/reperfusion injury. Aging (Albany NY) 2020; 12:10951-10968. [PMID: 32518214 PMCID: PMC7346066 DOI: 10.18632/aging.103308] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 04/27/2020] [Indexed: 12/13/2022]
Abstract
Ischemic stroke, a serious neurological disease, is associated with cell death, axonal and dendritic plasticity, and other activities. Anti-inflammatory, anti-apoptotic, promote dendritic and synaptic plasticity are critical therapeutic targets after ischemic stroke. Fibroblast growth factor-2 (FGF2), which is involved in the cyclic adenosine monophosphate (cAMP)/protein kinase A (PKA)/CAMP response element (CRE)-binding protein (CREB) pathway, has been shown to facilitate dendritic and synaptic plasticity. Salidroside (Sal) has been reported to have anti-inflammatory, anti-oxidative, and anti-apoptotic effects; however, the underlying mechanisms of Sal in promoting dendritic and synaptic plasticity remain unclear. Here, the anti-inflammatory, anti-apoptotic, dendritic and synaptic plasticity effects of Sal were investigated in vitro in PC12 cells under oxygen-glucose deprivation/reoxygenation (OGD/R) conditions and in vivo in rats with middle cerebral artery occlusion/reperfusion (MCAO/R). We investigated the role of Sal in promoting dendritic and synaptic plasticity in the ischemic penumbra and whether the FGF2-mediated cAMP/PKA/CREB pathway was involved in this process. The present study demonstrated that Sal could significantly inhibit inflammation and apoptosis, and promote dendritic and synaptic plasticity. Overall, our study suggests that Sal is an effective treatment for ischemic stroke that functions via the FGF2-mediated cAMP/PKA/CREB pathway to promote dendritic and synaptic plasticity.
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Affiliation(s)
- Sisi Li
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, PR China.,Department of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, PR China
| | - Yechen Lu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, PR China.,Department of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, PR China
| | - Daofang Ding
- Department of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, PR China
| | - Zhenzhen Ma
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, PR China.,Department of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, PR China
| | - Xiangxin Xing
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, PR China.,Department of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, PR China
| | - Xuyun Hua
- Department of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, PR China.,Department of Trauma and Orthopedics, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, PR China
| | - Jianguang Xu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, PR China.,Department of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, PR China.,Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai 200040, PR China
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Gut microbiota-dependent Trimethylamine N-Oxide are related with hip fracture in postmenopausal women: a matched case-control study. Aging (Albany NY) 2020; 12:10633-10641. [PMID: 32482913 PMCID: PMC7346070 DOI: 10.18632/aging.103283] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 04/27/2020] [Indexed: 12/11/2022]
Abstract
The study evaluates the serum levels of Trimethylamine N-Oxide (TMAO), a gut microbial metabolite, in 286 postmenopausal women with hip fracture. From January 1, 2018 to December 31, 2018, eligible patients were included. Same women without fracture mated age were enrolled. TMAO serum levels were tested by ultra-high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS). The serum levels of TMAO were significantly higher in patients with hip fracture than in those controls (P<0.001). The serum levels of TMAO were also higher in patients with hip fracture only than in those who also had upper limb fracture (P=0.001). High level of TMAO was proved a predictor of both hip fracture and had upper limb fracture combined hip fracture, after the adjustment of other existing risk factors [e.g., for each 1 uM increase of TMAO, odd ratio 1.16 (95% CI, 1.07–1.25), P < 0.001; and 1.12 (95% CI, 1.03–1.26), P=0.008, respectively]. In summary, increased TMAO serum levels associated with high risk of hip fracture, suggesting that increase TMAO may contribute to osteoporosis and fracture in postmenopausal women.
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60
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Wang J, Guan Q, Sheng Y, Yang Y, Guo L, Li W, Gu Y, Han C. The potential predictive value of salivary cortisol on the occurrence of secondary cognitive impairment after ischemic stroke. Neurosurg Rev 2020; 44:1103-1108. [PMID: 32314117 DOI: 10.1007/s10143-020-01256-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 12/17/2019] [Accepted: 01/29/2020] [Indexed: 10/24/2022]
Abstract
In this study, we aimed to investigate the relationship between salivary cortisol content and secondary mild cognitive impairment (MCI), thereby supporting the prediction of MCI in clinical practice. In this study, the salivary cortisol levels were examined in 120 patients with MCI after cerebral ischemic stroke (CIS) (CIS-MIC) and 80 CIS patients without MIC (CIS). The clinical data were compared among these patients with different cortisol levels. The salivary level of cortisol was significantly higher in patients with CIS-MIC (0.85-3.65 nmol/L) than that in those with CIS (0.52-1.21 nmol/L). The categorized analysis by CIS-MIC quartile showed that patient age, hyperlipidemia, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), etc. were significantly increased with increasing salivary cortisol levels. Moreover, univariate and multivariate logistic regression analyses revealed that the MCI risk of patients in the first quartile was 0.35 and 0.41 times, respectively, of the fourth quartile. Multiple linear regression showed that patient age, the time of rescue, and the salivary cortisol level were independent factors in the Mini-Mental State Exam (MMSE) score of MCI patients. Meanwhile, the receiver operating characteristic (ROC) curve showed that the area under the curve of salivary cortisol as a diagnostic marker for MCI after CIS was 0.982, with sensitivity of 0.973 and specificity of 0.980. In this study, we found that salivary cortisol level was an independent risk factor of MCI after CIS. A higher salivary cortisol level indicated a higher probability of MCI occurrence, and salivary cortisol level can be used as a predictive marker for MCI occurrence.
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Affiliation(s)
- Jin Wang
- Department of Pharmacy, The Second Affiliated Hospital of Jiaxing University, Jiaxing, 314000, China
| | - Qiaobing Guan
- Department of Neurology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, 314000, China
| | - Yongjia Sheng
- Department of Pharmacy, The Second Affiliated Hospital of Jiaxing University, Jiaxing, 314000, China
| | - Yi Yang
- Department of Pharmacy, The Second Affiliated Hospital of Jiaxing University, Jiaxing, 314000, China
| | - Li Guo
- Department of Center Laboratory, The Second Affiliated Hospital of Jiaxing University, Jiaxing, 314000, China
| | - Wenyan Li
- Department of Pharmacy, The Second Affiliated Hospital of Jiaxing University, Jiaxing, 314000, China
| | - Yanling Gu
- Department of Pharmacy, The Second Affiliated Hospital of Jiaxing University, Jiaxing, 314000, China.
| | - Chenyang Han
- Department of Pharmacy, The Second Affiliated Hospital of Jiaxing University, Jiaxing, 314000, China.
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61
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Gui YK, Li Q, Liu L, Zeng P, Ren RF, Guo ZF, Wang GH, Song JG, Zhang P. Plasma levels of ceramides relate to ischemic stroke risk and clinical severity. Brain Res Bull 2020; 158:122-127. [PMID: 32165273 DOI: 10.1016/j.brainresbull.2020.03.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 01/23/2020] [Accepted: 03/06/2020] [Indexed: 01/05/2023]
Abstract
Recent studies have suggested that specific plasma ceramides are independently associated with atherosclerosis and cardiovascular diseases, but it is currently unknown whether plasma ceramide levels are associated with ischemic stroke. Here, we examined whether ceramides were associated with both ischemic stroke risk and clinical severity at admission. We measured three previously identified high-risk plasma ceramide molecules [Cer(d18:1/16:0), Cer(d18:1/22:0), and Cer(d18:1/24:0)] in 202 patients with acute ischemic stroke and 202 age and sex matched control cases. Plasma ceramides levels were measured by a targeted liquid chromatography-tandem mass spectrometry assay at baseline. The median age of the 202 stroke patients was 66 (interquartile range [IQR], 58-75) years and 54.0 % were men. Plasma levels of C16:0, C22:0, and C24:0 ceramides in stroke patients were significantly higher than in those control cases (P < 0.001, all). In multivariate logistic regression analysis adjusted for other risk factors, higher levels of C16:0, C22:0, and C24:0 ceramides were associated with higher risk of ischemic stroke (odd ratio [OR] for one IQR increase: 2.15[1.42-2.99]; 2.90[2.13-4.01] and 1.29[1.10-1.69]; respectively). At admission, 103 patients (51.0 %) had a minor stroke (NIHSS < 6). In these patients, plasma levels of C16:0, C22:0, and C24:0 ceramides were lower than that observed in patients with moderate-to-high clinical severity (P < 0.001, all). In multivariate logistic regression analysis adjusted for other risk factors, higher levels of C16:0, C22:0, and C24:0 ceramides were associated with higher risk of moderate-to-high stroke (OR for one IQR increase: 2.96 [2.05-4.22], 3.03 [2.01-4.25] and 1.72 [1.25-3.31], respectively). An elevated plasma levels of ceramides were predictors of both risk and severity at admission in ischemic stroke patients. The underlying mechanisms of these associations remain to be investigated.
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Affiliation(s)
- Yong-Kun Gui
- Department of Neurology, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Qing Li
- Department of Neurology, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Li Liu
- Department of Neurology, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Ping Zeng
- Department of Neurology, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Rui-Fang Ren
- Department of Neurology, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Zhen-Fang Guo
- Department of Neurology, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Gui-Hua Wang
- Department of Neurology, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Jing-Gui Song
- Department of Neurology, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China.
| | - Ping Zhang
- Department of Neurology, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China.
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Prognostic Value of NT-proBNP After Ischemic Stroke: A Systematic Review and Meta-analysis of Prospective Cohort Studies. J Stroke Cerebrovasc Dis 2020; 29:104659. [PMID: 32067852 DOI: 10.1016/j.jstrokecerebrovasdis.2020.104659] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 01/06/2020] [Accepted: 01/10/2020] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Many studies have evaluated the relationship between N-terminal pro-brain natriuretic peptide (NT-proBNP) and its prognostic value in ischemic stroke. However, a widespread consensus has not been reached. Therefore, we completed a meta-analysis to evaluate the prognostic significance of NT-proBNP for mortality and functional outcome in patients with ischemic stroke. METHODS We performed a systematic search and review using the PubMed and EMBASE databases to identify literature that reported a correlation between NT-proBNP and mortality and functional outcome in ischemic stroke patients. RESULTS Eleven studies inclusive of 10,498 patients met the inclusion criteria. Elevated plasma NT-proBNP levels were associated with increased risk of mortality in ischemic stroke patients (all-cause mortality: odds ratio [OR] = 2.43, 95% confidence interval [CI] 1.62-3.64, P < .001, I2=74.3%; cardiovascular mortality: OR = 2.01, 95% CI 1.55-2.61, P < .001, I2 = 42.6%). In addition, unfavorable functional outcomes were observed in patients with higher levels of NT-proBNP (OR = 1.68, 95% CI 1.13-2.50, P = .01, I2 = 90.8%) after ischemic stroke. CONCLUSIONS This meta-analysis demonstrates that NT-proBNP could be a predictor of mortality and functional outcome in ischemic stroke patients.
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Yang CD, Cheng ML, Liu W, Zeng DH. Association of serum retinoic acid with depression in patients with acute ischemic stroke. Aging (Albany NY) 2020; 12:2647-2658. [PMID: 32040942 PMCID: PMC7041768 DOI: 10.18632/aging.102767] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 01/12/2020] [Indexed: 12/17/2022]
Abstract
Retinoic acid (RA), produced by the metabolism of vitamin A, makes effects on depression and stroke. This study was aimed to evaluate the relationship between RA levels in serum and post-stroke depression (PSD). A single-center (Chengdu, China) prospective cohort study was conducted on patients with acute ischemic stroke. The RA serum level was measured at admission. The PSD was assessed in the 3-month follow-up. The RA-PSD relationship was evaluated with conditional logistic regression. In total, 239 ischemic stroke cases and 100 healthy controls were included. The median RA serum level in patients with ischemic stroke was 2.45 ng/ml (interquartile range [IQR], 0.72-4.33), lower(P<0.001) than 3.89 ng/ml of those in control cases ([IQR]: 2.62-5.39). The crude and adjusted odds ratios [OR] (and 95% confidence intervals [CI]) of PSD associated with an IQR increase for RA were 0.54 (0.44, 0.67) and 0.66 (0.52, 0.79), respectively. Higher ORs of PSD associated with reduced RA levels (
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Affiliation(s)
- Cai-Di Yang
- Department of Neurology, Eastern Hospital, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu 610101, China
| | - Ming-Li Cheng
- Department of Neurology, People's Hospital of Jianyang, Jianyang 641400, China
| | - Wen Liu
- The Clinical Laboratory Department, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China
| | - Ding-Hua Zeng
- Department of Neurology, Eastern Hospital, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu 610101, China
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Wang P, Fan J, Yuan L, Nan Y, Nan S. Serum Neurofilament Light Predicts Severity and Prognosis in Patients with Ischemic Stroke. Neurotox Res 2020; 37:987-995. [PMID: 31898161 DOI: 10.1007/s12640-019-00159-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 12/12/2019] [Accepted: 12/22/2019] [Indexed: 12/13/2022]
Abstract
Serum neurofilaments are markers of axonal injury. We investigated whether serum neurofilament light (sNfL) is a potential prognostic marker of functional outcome in Chinese patients with acute ischemic stroke (AIS). From May 2015 to December 2018, consecutive patients with AIS from the Department of Neurology of the Second Hospital of Jilin University were included. sNfL concentration was tested at baseline, and stroke severity was analyzed at admission using the NIHSS score. Functional outcome was assessed at discharge by the modified Rankin scale (mRS). The sNfL concentration was tested in 343 patients with a median value of 17.8 (IQR, 13.4-25.2) pg/ml. sNfL concentration paralleled lesion size (P = 0.035). At admission, 174 patients were defined as moderate-to-high stroke (NIHSS ≥ 5); the sNfL concentration in those patients were higher than that observed in patients with minor clinical severity [21.2 (IQR, 15.1-31.7) vs. 14.9 (11.8-19.4) pg/ml, P < 0.001]. For each 1 quartile increase of sNfL concentration, the unadjusted and adjusted risk of moderate-to-high stroke increased by 202% (with the OR of 3.04 (95% CI 2.15-4.32), P < 0.001) and 102% [2.02 (1.10-3.16), P = 0.001), respectively. At discharge, 85 patients (24.8%) had poor functional outcome (mRS, 3-6); the sNfL concentration in those patients were higher than that observed in patients with good outcome [24.1 (IQR, 18.8-33.9) vs. 15.7 (11.9-21.8) pg/ml, P < 0.001]. For each 1 quartile increase of sNfL concentration, the unadjusted and adjusted risk of poor outcome increased by 236% [with the OR of 3.36 (95% CI 2.23-5.06), P < 0.001] and 102% [2.29 (1.37-3.82), P < 0.001], respectively. The results show sNfL is meaningful blood biomarker to monitor stroke severity and functional outcome in ischemic stroke, suggesting that sNfL may play a role in stroke progression.
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Affiliation(s)
- Peng Wang
- Department of Neurology, The Second Hospital of Jilin University, No.218, Ziqiang Street, Nanguan District, Changchun, 130041, Jilin Province, People's Republic of China
| | - Jia Fan
- Department of Neurology, The Second Hospital of Jilin University, No.218, Ziqiang Street, Nanguan District, Changchun, 130041, Jilin Province, People's Republic of China
| | - Ling Yuan
- Pharmacy College of Ningxia Medical University, Yinchuan, Ningxia, People's Republic of China
| | - Yi Nan
- Traditional Chinese Medicine College of Ningxia Medical University, Yinchuan, Ningxia, People's Republic of China
| | - Shanji Nan
- Department of Neurology, The Second Hospital of Jilin University, No.218, Ziqiang Street, Nanguan District, Changchun, 130041, Jilin Province, People's Republic of China.
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Quan L, Yi J, Zhao Y, Zhang F, Shi XT, Feng Z, Miller HL. Plasma trimethylamine N-oxide, a gut microbe-generated phosphatidylcholine metabolite, is associated with autism spectrum disorders. Neurotoxicology 2020; 76:93-98. [PMID: 31704102 PMCID: PMC7385710 DOI: 10.1016/j.neuro.2019.10.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 10/15/2019] [Accepted: 10/28/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The compositions of the gut microbiota and its metabolites were altered in individuals with Autism Spectrum Disorder (ASD). The aim of this study was to assess whether plasma levels of gut-derived metabolite trimethylamine N-oxide (TMAO) were associated with ASD and the degree of symptom severity. METHODS From September 2017 to January 2019, a total of three hundred and twenty-eight Chinese children (164 with ASD and 164 their age-sex matched control subjects) aged 3-8 years were included. TMAO levels in plasma were determined using high-performance liquid chromatography tandem mass spectrometry (LC/MS/MS). Logistic regression analysis was used to examine the TMAO-ASD association. RESULTS In the study, the median age of the ASD group was 5 years (interquartile range [IQR], 4-6 years) and 129 (78.7%) were boys. The median plasma levels of TMAO in children with ASD and typically-developing (TD) children at admission were 4.2 (IQR, 3.0-5.6) μmol/l and 3.0 (2.0-4.4) μmol/l, respectively (P < 0.001). For each 1 μmol/l increase of plasma TMAO, the unadjusted and adjusted risk of ASD would be increased by 54% (with the odds ratios [OR] of 1.54; 95% confidence intervals [CI]: 1.32-1.78; P < 0.001) and 27% (1.27 [1.10-1.45], P < 0.001), respectively. Symptom severity was classified as mild-to-moderate (CARS < 37) for 66 children with ASD (40.2%). In these children, the plasma levels of TMAO were lower than in the 98 children with ASD (59.8%) whose symptoms were classified as severe (CARS > 36) (3.5[2.5-4.9] μmol/l vs. 4.5(3.7-6.0) μmol/l; P < 0.001). For each 1 μmol/l increase of plasma TMAO, the unadjusted and adjusted risk of severe autism would be increased by 61% (with the OR of 1.61 [95% CI 1.28-2.01], P < 0.001) and 31% (1.31 [1.08-1.49], P < 0.001), respectively. CONCLUSIONS Elevated plasma levels of TMAO were associated with ASD and symptom severity.
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Affiliation(s)
- Lijuan Quan
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China.
| | - Jinping Yi
- Department of Clinical Laboratory, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yue Zhao
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Feng Zhang
- Department of Pediatric Neurology and Rehabilitation, Maternal and Child Health Hospital of Ganzhou, Ganzhou, China
| | - Xiao-Tong Shi
- Autism Treatment Center, Rehabilitation Medical College of Capital Medical University, Beijing, China
| | - Zhen Feng
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Haylie L Miller
- Department of Physical Therapy, University of North Texas Health Science Center, Fort Worth, USA.
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Lu X, Duan J, Cheng Q, Lu J. The association between serum growth differentiation factor-15 and 3-month depression after acute ischemic stroke. J Affect Disord 2020; 260:695-702. [PMID: 31561112 DOI: 10.1016/j.jad.2019.09.037] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 08/17/2019] [Accepted: 09/08/2019] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The aim of this study was to assess the association between serum growth differentiation factor-15(GDF-15) and 3-month depression after acute ischemic stroke. METHODS In this single-center prospective study, patients with first-ever acute ischemic stroke between March 2017 and November 2018 were included. Neurological and neuropsychological evaluations were conducted during the 3-month follow-up. The predictive value of GDF-15 to predict the post-stroke depression (PSD) within 3 months, was compared with other known predictors. RESULTS The median level of GDF-15 in 310 stroke patients was 1285(IQR, 846-1934) ng/l. During the 3-month follow-up, 76 patients were defined as depression (24.5%; 95% confidence interval [CI]: 17.9%-29.3%), and GDF-15 levels in those patients were nearly more than 1 time greater as compared with patients who were free of depression (P < 0.001). Using the ROC curves, GDF-15 serum level at 1660 ng/l predicted the PSD with the highest sensitivity and specificity [67.1% and 77.4%, respectively; AUC=0.78, 95%CI: 0.72-0.84; P < 0.001]. Interestingly, When GDF-15 was added to the model containing established significant risk factors, AUROC (standard error) was increased from 0.81(0.029) to 0.88(0.020). A significant difference in the AUC between the established risk factors alone and the addition of GDF-15 was observed (difference, 0.07[0.009]; P = 0.001). In a multivariate model using the elevated levels of GDF-15 (≥cut-off=1660 ng/l) vs. normal (<cut-off) together with the other significant clinical variables, the marker displayed predictive information (PSD: OR = 4.11 [95% CI, 2.05-6.32]; P < 0.001]). CONCLUSIONS In summary, GDF-15 serum levels at admission are associated with depression later developed in patients with ischemic stroke.
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Affiliation(s)
- Xiurong Lu
- Department of Neurology, Central Hospital of Zhoukou, No. 26, Renmin Road, Zhoukou, 646000, Henan Province, PR China.
| | - Jinfeng Duan
- Department of Psychiatry, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China
| | - Qian Cheng
- Department of Neurology, Central Hospital of Zhoukou, No. 26, Renmin Road, Zhoukou, 646000, Henan Province, PR China
| | - Junli Lu
- Department of Anus and Bowel, Central Hospital of Zhoukou, Zhoukou, PR China
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Chen Y, Zhan X, Zhao Q, Wei X, Xiao J, Yan C, Zhang W. Serum lipoprotein(a) and risk of hemorrhagic stroke among incident peritoneal dialysis patients: a large study from a single center in China. Ren Fail 2019; 41:800-807. [PMID: 31498021 PMCID: PMC6746282 DOI: 10.1080/0886022x.2019.1659151] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 08/15/2019] [Accepted: 08/16/2019] [Indexed: 11/17/2022] Open
Abstract
Background: This retrospective study investigated whether baseline serum lipoprotein(a) (Lp(a)) may predict subsequent stroke in patients under chronic peritoneal dialysis (PD). Methods: Eight hundred and sixty incident PD patients, treated from 1 November 2005 to 28 February 2017, were enrolled, and followed until discontinuation of PD, death, or 31 May 2017. Hemorrhagic or ischemic stroke was the primary outcome. The population was stratified by baseline serum Lp(a) tertile. The risk of each stroke subtype was analyzed using the Cox proportional hazard models. Adjustments were made for: age; gender; history of stroke and hypertension; systolic blood pressure; lipid-lowering, antiplatelet and antihypertensive medications; laboratory profiles including hemoglobin, serum albumin, calcium, triglyceride, total and low-density lipoprotein cholesterol; and apolipoprotein A1. Results: Among the 860 participants, 19.3% and 4.1% had diabetes mellitus and a history of stroke, respectively. The median baseline serum Lp(a) was 328 (172-585) mg/L. After 28 (14-41) months of follow-up, 33 (3.84%) and 12 (1.40%) patients developed hemorrhagic and ischemic stroke, respectively. Participants in the highest Lp(a) tertile had a significantly lower risk of hemorrhagic stroke compared with those in the lowest tertile (hazard ratio (HR) 0.3, 95% confidence interval (CI) 0.1-0.86; p = .026); the rates of ischemic stroke were comparable among the tertiles. Each 10 mg/L rise in serum Lp(a) was associated with a 2% (95% CI 0.96-1; p = .033) lower risk of hemorrhagic stroke. Conclusions: Among patients with incident PD, a higher serum Lp(a) level may predict a lower risk of hemorrhagic stroke.
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Affiliation(s)
- Yanbing Chen
- Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xiaojiang Zhan
- Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Qing Zhao
- Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xin Wei
- Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jun Xiao
- Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Caixia Yan
- Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Wei Zhang
- Department of Respiration, The First Affiliated Hospital of Nanchang University, Nanchang, China
- CONTACT Wei Zhang Department of Respiration, The First Affiliated Hospital of Nanchang University, 17# Yongwai Street, Nanchang 330006, China
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Wang J, Huang Q, Ding J, Wang X. Elevated serum levels of brain-derived neurotrophic factor and miR-124 in acute ischemic stroke patients and the molecular mechanism. 3 Biotech 2019; 9:386. [PMID: 31656724 PMCID: PMC6778548 DOI: 10.1007/s13205-019-1914-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 09/21/2019] [Indexed: 10/25/2022] Open
Abstract
Brain-derived neurotrophic factor (BDNF) and microRNAs (miRNAs) play a significant role in the pathogenesis of acute ischemic stroke (AIS). The present study investigates the elevated expression of BDNF and miR-124 in AIS patients. In the present study, serum samples from AIS patients and healthy controls were collected to determine the regulatory role and mechanism of operation of BDNF and to determine the regulatory miRNAs involved in AIS. Using bioinformatics analysis, we identified putative and regulatory miR-124. The effect of miR-124 on BDNF expression was examined in human neuronal cell lines. Moreover, the function of miR-124 in regulating BDNF was analyzed by assessing the serum level of BDNF in both AIS patients and healthy controls. The results indicate that the BDNF level of AIS patients is very low compared with that of controls. In contrast, real-time polymerase chain reaction (RT-PCR) data revealed a very high serum level of miR-124 in AIS patients relative to healthy individuals. The associations of the National Institutes of Health (NIH) stroke scale (NIHSS) score with BDNF and BDNF-related miR-124 serum levels were calculated using Pearson's/Spearman's correlation coefficient. The findings revealed a negative correlation between NIHSS score and BDNF level, whereas a positive correlation was observed between NIHSS score and miR-124. In addition, the relationship between serum BDNF and miR-124 was negative in AIS patients. In conclusion, this study provides strong evidence that serum BDNF and the BDNF-regulatory miR-124 may serve as molecular markers for AIS.
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Affiliation(s)
- Jie Wang
- Department of Neurology, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, No 1111 of XianXia Road, Shanghai, 200335 China
| | - Qiong Huang
- Department of Neurology, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, No 1111 of XianXia Road, Shanghai, 200335 China
| | - Ji Ding
- Department of Neurology, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, No 1111 of XianXia Road, Shanghai, 200335 China
| | - Xiaoping Wang
- Department of Neurology, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, No 1111 of XianXia Road, Shanghai, 200335 China
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Spagnolello O, De Michele M, Lorenzano S, Cerulli Irelli E, Naitana F, Falcou A, Letteri F, Bachetoni A, Collepardo D, Bertazzoni G, Toni D. Copeptin Kinetics in Acute Ischemic Stroke May Differ According to Revascularization Strategies: Pilot Data. Stroke 2019; 50:3632-3635. [PMID: 31630623 DOI: 10.1161/strokeaha.119.025433] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose- Prognostic value of copeptin in acute ischemic stroke has been widely reported. This study aimed to evaluate copeptin temporal profile according to revascularization strategies and the development of brain edema and hemorrhagic transformation. Methods- Plasma copeptin and brain edema and hemorrhagic transformation assessed by computed tomography/magnetic resonance imaging were evaluated upon admission (T0), at 24 hours (T1), and between the third and fifth day of hospitalization (T2) in 34 acute ischemic stroke patients. Results- Median copeptin concentration was 50.71 pmol/L at T0, 18.31 pmol/L at T1, and 10.92 pmol/L at T2. Copeptin at T1 was higher in patients with medium/severe brain edema at T2 (32.25 versus 13.67 pmol/L; P=0.038) and hemorrhagic transformation at T1 (93.10 versus 13.67 pmol/L; P<0.003) and T2 (85.70 versus 14.45 pmol/L; P=0.024). Copeptin level drop (CopΔT1-T0) was significantly steeper in patients receiving revascularization, particularly in those undergoing combined therapy (-129.34 versus -5.43 pmol/L; P=0.038). ΔT1-T0 also correlated with Thrombolysis in Cerebral Infarction score (P<0.001). Conclusions- Copeptin resulted associated with brain edema and hemorrhagic transformation in acute ischemic stroke, and its drop at 24 hours may mirror effective brain vessel recanalization.
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Affiliation(s)
- Ornella Spagnolello
- From the Emergency Department (O.S., F.N., G.B.), Policlinico Umberto I Hospital, Sapienza University, Rome, Italy
| | - Manuela De Michele
- Department of Human Neurosciences (M.D.M., S.L., E.C.I., A.F., F.L., D.T.), Policlinico Umberto I Hospital, Sapienza University, Rome, Italy
| | - Svetlana Lorenzano
- Department of Human Neurosciences (M.D.M., S.L., E.C.I., A.F., F.L., D.T.), Policlinico Umberto I Hospital, Sapienza University, Rome, Italy
| | - Emanuele Cerulli Irelli
- Department of Human Neurosciences (M.D.M., S.L., E.C.I., A.F., F.L., D.T.), Policlinico Umberto I Hospital, Sapienza University, Rome, Italy
| | - Federico Naitana
- From the Emergency Department (O.S., F.N., G.B.), Policlinico Umberto I Hospital, Sapienza University, Rome, Italy
| | - Anne Falcou
- Department of Human Neurosciences (M.D.M., S.L., E.C.I., A.F., F.L., D.T.), Policlinico Umberto I Hospital, Sapienza University, Rome, Italy
| | - Federica Letteri
- Department of Human Neurosciences (M.D.M., S.L., E.C.I., A.F., F.L., D.T.), Policlinico Umberto I Hospital, Sapienza University, Rome, Italy
| | - Alessandra Bachetoni
- Department of Experimental Medicine (A.B., D.C.), Policlinico Umberto I Hospital, Sapienza University, Rome, Italy
| | - Daniela Collepardo
- Department of Experimental Medicine (A.B., D.C.), Policlinico Umberto I Hospital, Sapienza University, Rome, Italy
| | - Giuliano Bertazzoni
- From the Emergency Department (O.S., F.N., G.B.), Policlinico Umberto I Hospital, Sapienza University, Rome, Italy
| | - Danilo Toni
- Department of Human Neurosciences (M.D.M., S.L., E.C.I., A.F., F.L., D.T.), Policlinico Umberto I Hospital, Sapienza University, Rome, Italy
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Qiao J, Zhou K, Huang C, Fu S, Xing Y, Zhang B. Comparison of serum Lp-PLA2 levels in ischemic stroke patients with H-type hypertension or non-H-type hypertension. J Clin Lab Anal 2019; 34:e23068. [PMID: 31630457 PMCID: PMC7031582 DOI: 10.1002/jcla.23068] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 09/22/2019] [Accepted: 09/24/2019] [Indexed: 01/15/2023] Open
Abstract
Background Increased serum Lp‐PLA2 levels have been reported in patients who experienced an ischemic stroke; however, the relationship between Lp‐PLA2 and H‐type hypertension in patients with ischemic stroke remains unclear. Methods In the present study, we investigated the correlation between serum Lp‐PLA2 and H‐type hypertension in patients with ischemic stroke. A total of 135 patients who experienced acute ischemic stroke were enrolled in Tianjin Huanhu Hospital during October 2015 to May 2016. The demographic characteristics of the patients were collected, and biochemical parameters were detected. Results Among the 135 patients, 111 patients had essential hypertension, including 41 patients with H‐type hypertension and 70 with non‐H‐type hypertension. There were higher proportions of males and patients with diabetes mellitus in the H‐type hypertension group compared with the non‐H‐type hypertension group (P < .05). Lp‐PLA2, glucose, and LDL‐C levels were higher in the H‐type hypertension group than in the non‐H‐type hypertension group (P < .05). Multivariate logistic regression showed that Lp‐PLA2 levels >208.46 mg/L were independently associated with H‐type hypertension in patients with ischemic stroke (OR: 2.560, 95% CI: 1.085‐6.040, P = .032). The area under the ROC curve of Lp‐PAL2 levels in the H‐type hypertension group was 0.665 (95% CI: 0.561‐0.768, P = .004). Conclusion Synergetic effects of H‐type hypertension and Lp‐PLA2 levels were noted in the pathogenesis of ischemic stroke.
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Affiliation(s)
- Jie Qiao
- Tianjin Key Laboratory of Cerebral Vessels and Neural DegenerationTianjin Neurosurgical InstituteTianjin Huanhu HospitalTianjinChina
| | - KuiChen Zhou
- Department of Clinical LaboratoryThe First Affiliated Hospital of Jiamusi UniversityJiamusiChina
| | - Chao Huang
- Tianjin Key Laboratory of Cerebral Vessels and Neural DegenerationTianjin Neurosurgical InstituteTianjin Huanhu HospitalTianjinChina
| | - Siwen Fu
- Tianjin Key Laboratory of Cerebral Vessels and Neural DegenerationTianjin Neurosurgical InstituteTianjin Huanhu HospitalTianjinChina
| | - Yonghong Xing
- Tianjin Key Laboratory of Cerebral Vessels and Neural DegenerationTianjin Neurosurgical InstituteTianjin Huanhu HospitalTianjinChina
| | - Biao Zhang
- Tianjin Key Laboratory of Cerebral Vessels and Neural DegenerationTianjin Neurosurgical InstituteTianjin Huanhu HospitalTianjinChina
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Huang YQ, Huang JY, Liu L, Chen CL, Yu YL, Tang ST, Zhang B, Feng YQ. Relationship between triglyceride levels and ischaemic stroke in elderly hypertensive patients. Postgrad Med J 2019; 96:128-133. [DOI: 10.1136/postgradmedj-2019-136961] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 09/04/2019] [Accepted: 09/30/2019] [Indexed: 01/30/2023]
Abstract
BackgroundAlthough hyperlipidaemia was a well-known risk factor for ischaemic stroke, the association between triglyceride and first ischaemic stroke remains uncertain.ObjectivesThe present study attempted to explore the relationship between triglyceride and first ischaemic stroke in a Chinese community elderly patients with hypertension.Methods and resultsThis was a retrospective cohort study. We enrolled 3249 consecutive elderly patients with hypertension from a community in China between January 2010 and December 2011. Patients were divided into four groups based on the quartiles of triglyceride. Multivariate Cox regression analysis, subgroup and interaction test were performed to evaluate the relationship between triglyceride and first ischaemic stroke. There were a total of 3249 participants including 1455 male and 1794 female, with a mean age of 71.36±7.18 years. At an average follow-up of 5.5 years, 205 patients were identified to have first ischaemic stroke. After adjustment for potential confounders, using the lowest quartiles of triglyceride as the reference, multivariable HR (95% CI) for first ischaemic stroke increased in parallel with the quartiles of triglyceride (HRs were 1.56 (95% CI 1.07 to 2.51), 1.74 (95% CI 1.07 to 2.84) and 1.85 (95% CI 1.05 to 2.89)) from the second to the fourth quartiles, respectively (p=0.002 for trend). Subgroup and interaction analysis showed that there was no interactive effect on triglyceride and first ischaemic stroke.ConclusionTriglyceride was an independent risk factor for first ischaemic stroke among Chinese elderly patients with hypertension.
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Wang Z, Li B, Wang Y, Maimaitili A, Qin H, Dangmurenjiafu G, Wang S. The association between serum adiponectin and 3-month outcome after ischemic stroke. Cardiovasc Diabetol 2019; 18:105. [PMID: 31412946 PMCID: PMC6694580 DOI: 10.1186/s12933-019-0908-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Accepted: 08/07/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Although adiponectin is a major adipocytokine that affects the pathogenesis of various cardiovascular diseases, its clinical significance in stroke remains controversial. The purpose of this study was to assess the impact of serum adiponectin levels on functional prognosis in patients with ischemic stroke. METHODS This was a prospective, observational cohort study. Consecutive first-ever ischemic stroke patients without any pre-morbid handicap admitted to our hospital were identified from December 2017 to December 2018. Serum concentration of adiponectin was routinely measured within the first 24 h after admission by a commercially available sandwich ELISA. Associations between adiponectin and either clinical severity at admission, poor outcomes or mortality at 3-month after admission were analyzed using logistic regression to obtain odds ratios (OR) and 95% confidence intervals (CI). RESULTS The serum level of adiponectin was obtained in 227 patients with a median value of 7.0 μg/ml, which was significantly higher (P < 0.001) than in those heathy control. Adiponectin levels were associated with moderate-to-high stroke, and risk increased by 12% (OR = 1.12; 95% CI 1.03-1.25; P = 0.002). Patients with a poor outcome and nonsurvivors had significantly increased adiponectin levels on admission (P < 0.001, all). In multivariate logistic regression analysis, adiponectin was an independent predictor of functional outcome and mortality, and risk increased by 24% (OR = 1.24, 95% CI 1.13-1.37; P < 0.001) and 31% (1.31 [1.18-1.46], P < 0.001), respectively. Kaplan-Meier analysis suggested that the patients with high serum adiponectin levels had a higher risk of death than those patients with low levels (log-rank test P < 0.001). CONCLUSIONS Our results show that high adiponectin is associated with stroke severity and support the hypothesis that adiponectin can be serve as a biomarker of poor outcome after stroke, independent of baseline variables. Trial registration ChiCTR-OPC-17013501. Retrospectively Registered 21 September 2017.
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Affiliation(s)
- Zengliang Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Fanyang Road, Fengtai District, Beijing, 100070, People's Republic of China
- Department of Neurosurgery, First Affiliated Hospital of Xinjiang Medical University, Ürümqi, China
| | - Bo Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Fanyang Road, Fengtai District, Beijing, 100070, People's Republic of China
| | - Yongxin Wang
- Department of Neurosurgery, First Affiliated Hospital of Xinjiang Medical University, Ürümqi, China
| | - Aisha Maimaitili
- Department of Neurosurgery, First Affiliated Hospital of Xinjiang Medical University, Ürümqi, China
| | - Hu Qin
- Department of Neurosurgery, First Affiliated Hospital of Xinjiang Medical University, Ürümqi, China
| | - Geng Dangmurenjiafu
- Department of Neurosurgery, First Affiliated Hospital of Xinjiang Medical University, Ürümqi, China
| | - Shuo Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Fanyang Road, Fengtai District, Beijing, 100070, People's Republic of China.
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Radisauskas R, Tamosiunas A, Kranciukaite-Butylkiniene D, Milinaviciene E, Malinauskiene V, Bernotiene G, Luksiene D, Virviciute D, Rastenyte D. Long-term survival after stroke in Lithuania: Data from Kaunas population-based stroke registry. PLoS One 2019; 14:e0219392. [PMID: 31291344 PMCID: PMC6619798 DOI: 10.1371/journal.pone.0219392] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 06/22/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND There is a lack of reliable epidemiological data on long-term survival trends of first-ever stroke patients in Lithuanian population. AIMS To evaluate trends in long-term survival after stroke and to determine the influence of some sociodemographic and lifestyle factors, time and subtype of stroke, and stroke care on survival. METHODS All stroke events included in Kaunas stroke register database were ascertained and validated according to the standardized criteria outlined by the WHO MONICA Project. The study included all patients in Kaunas (Lithuania) city aged 25 to 64 years who experienced a stroke between 1986 and 2011. Death time was confirmed by the Office for National Death Statistics. Estimates of stroke long-term survival data and factors influencing survival changes were made by applying the Kaplan-Meier and Cox regression analysis. RESULTS During the study period, 4,129 persons aged 25-64 years suffered from a first-ever stroke: 2,215 (53.6%) of them were men and 1,914 (46.4%)-women. Ischemic stroke was significantly more frequent in males than in females (80.6% and 78.6%, respectively, p<0.05) and subarachnoid hemorrhage was more common in women than in men (9.0% and 7.0% respectively, p <0.05). Of all first-ever stroke patients, 3,272 (79.2%) survived 1 year and 2,905 (70.4%) survived 5 years after stroke onset. The 1- and 5-years survival rate after a first-ever stroke in women was significantly higher as compared with that in men (Log-rank test p = 0.0001). The older (55-64 year) persons had poorer 1-year and 5-years survival rate as compared with persons in the younger (25-54 years) age group (Log-rank test p = 0.0001). Among persons with a first-ever stroke who had their stroke in 2007-2011, 1- and 5-year survival rate was higher compared with that in persons who had had a stroke in 1986-1990 and in 1997-2001 (Log-rank test p = 0.0001). The persons with a first-ever ischemic stroke had a better chance to survive first 1- and 5-years after stroke compared with persons who had intracerebral or subarachnoid haemorrhage. Only female gender was associated with higher 1- and 5-year survival rate after first-ever stroke. The older age, previous myocardial infarction and diabetes mellitus were associated with lower 1- and 5-year survival rate after first-ever stroke. CONCLUSIONS This population-based study of patients with first-ever stroke demonstrated that the long-term survival was better in women than men, and improved significantly in both men and women during the past decade. Long-term survival was better of those with first-ever ischemic stroke and of younger age- 25 to 54 years.
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Affiliation(s)
- Ricardas Radisauskas
- Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
- * E-mail:
| | - Abdonas Tamosiunas
- Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Daina Kranciukaite-Butylkiniene
- Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Family Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Egle Milinaviciene
- Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Rehabilitation, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Vilija Malinauskiene
- Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Gailute Bernotiene
- Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Dalia Luksiene
- Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Dalia Virviciute
- Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Daiva Rastenyte
- Department of Neurology, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Mengel A, Ulm L, Hotter B, Harms H, Piper SK, Grittner U, Montaner J, Meisel C, Meisel A, Hoffmann S. Biomarkers of immune capacity, infection and inflammation are associated with poor outcome and mortality after stroke - the PREDICT study. BMC Neurol 2019; 19:148. [PMID: 31269910 PMCID: PMC6607590 DOI: 10.1186/s12883-019-1375-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 06/23/2019] [Indexed: 02/20/2023] Open
Abstract
Background Almost 40% of stroke patients have a poor outcome at 3 months after the index event. Predictors for stroke outcome in the early acute phase may help to tailor stroke treatment. Infection and inflammation are considered to influence stroke outcome. Methods In a prospective multicenter study in Germany and Spain, including 486 patients with acute ischemic stroke, we used multivariable regression analysis to investigate the association of poor outcome with monocytic HLA-DR (mHLA-DR) expression, interleukin 6 (IL-6), interleukin 10 (IL-10), tumor necrosis factor alpha (TNF-alpha) and lipopolysaccharide-binding protein (LBP) as markers for immunodepression, inflammation and infection. Outcome was assessed at 3 months after stroke via a structured telephone interview using the modified Rankin Scale (mRS). Poor outcome was defined as a mRS score of 3 or higher which included death. Furthermore, a time-to-event analysis for death within 3 months was performed. Results Three-month outcome data was available for 391 patients. Female sex, older age, diabetes mellitus, atrial fibrillation, stroke-associated pneumonia (SAP) and higher National Institute of Health Stroke Scale (NIHSS) score as well as lower mHLA-DR levels, higher IL-6 and LBP-levels at day 1 were associated with poor outcome at 3 months in bivariate analysis. Furthermore, multivariable analysis revealed that lower mHLA-DR expression was associated with poor outcome. Female sex, older age, atrial fibrillation, SAP, higher NIHSS score, lower mHLA-DR expression and higher IL-6 levels were associated with shorter survival time in bivariate analysis. In multivariable analysis, SAP and higher IL-6 levels on day 1 were associated with shorter survival time. Conclusions SAP, lower mHLA-DR-expression and higher IL-6 levels on day one are associated with poor outcome and shorter survival time at 3 months after stroke onset. Trial registration www.clinicaltrials.gov, NCT01079728, March 3, 2010.
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Affiliation(s)
- A Mengel
- Department of Neurology Berlin, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10115, Berlin, Germany. .,Department of Neurology and Stroke, Universitätsklinik Tuebingen, Hoppe-Seyler-Str.3, 72076, Tuebingen, Germany.
| | - L Ulm
- Department of Neurology Berlin, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10115, Berlin, Germany.,Center for Clinical Research, The University of Queensland, Herston, Queensland, 4029, Australia
| | - B Hotter
- Department of Neurology Berlin, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10115, Berlin, Germany.,Center for Stroke Research Berlin, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10115, Berlin, Germany
| | - H Harms
- Department of Neurology Berlin, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10115, Berlin, Germany
| | - S K Piper
- Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,Berlin Institute of Health, Charitéplatz 1, D-10117, Berlin, Germany.,Berlin Institute of Health (BIH), Anna-Louisa-Karsch 2, 10178, Berlin, Germany
| | - U Grittner
- Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,Berlin Institute of Health, Charitéplatz 1, D-10117, Berlin, Germany.,Berlin Institute of Health (BIH), Anna-Louisa-Karsch 2, 10178, Berlin, Germany
| | - J Montaner
- Neurovascular Research Laboratory, Vall d'Hebron Institut de Recerca, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain
| | - C Meisel
- NeuroCure Clinical Research Center Berlin, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10115, Berlin, Germany
| | - A Meisel
- Department of Neurology Berlin, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10115, Berlin, Germany.,Center for Stroke Research Berlin, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10115, Berlin, Germany.,NeuroCure Clinical Research Center Berlin, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10115, Berlin, Germany
| | - S Hoffmann
- Department of Neurology Berlin, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10115, Berlin, Germany.,NeuroCure Clinical Research Center Berlin, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10115, Berlin, Germany
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Yang X, Peng J, Pang J, Wan W, Zhong C, Peng T, Bao K, Jiang Y. The Association Between Serum Macrophage Migration Inhibitory Factor and Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage. Neurotox Res 2019; 37:397-405. [PMID: 31267487 DOI: 10.1007/s12640-019-00072-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 05/27/2019] [Accepted: 06/07/2019] [Indexed: 01/09/2023]
Abstract
Inflammatory processes have long been implicated in the development of delayed cerebral ischemia (DCI) following aneurysmal subarachnoid hemorrhage (aSAH). Macrophage migration inhibitory factor (MIF) has been implicated in inflammation. The aim of this study was to assess whether serum levels of MIF at admission helps to predict which patients with aSAH would subsequently develop DCI. All patients with first-ever aSAH admitted between 2016 and 2017 were considered for inclusion in this prospective study. Primary study outcome was development of DCI at discharge. Serum levels of MIF, C-reactive protein (CRP), and interleukin-6 (IL-6) were tested at admission. The relation of serum levels of MIF at admission with DCI was assessed by the logistic regression models. In this study, 201 patients were included. A correlation between Hunt and Hess score and serum levels of MIF was found (r = 0.340; P < 0.001). Fifty-two of the 201 aSAH (25.9%) were defined as DCI, and the obtained MIF level in those patients was higher than in those patients without DCI [26.4 (IQR, 22.6-32.4) ng/ml vs. 20.4 (16.4-24.6) ng/ml; P < 0.001). As a continuous variable, MIF was associated with the risk of DCI. When serum level of MIF was elevated by each 1 ng/ml, the unadjusted risk of DCI was increased by 18% (OR = 1.18 [1.12-1.25], P < 0.001), while the adjusted risk was increased by 10% (1.10 [1.03-1.19], P = 0.001). With the area under the curve (AUC) of 0.780 (95% CI, 0.710-0.849), the MIF showed a great discriminatory ability for DCI than CRP (0.665, 0.582-0.748; P < 0.001) and IL-6 (0.721, 0.642-0.799; P = 0.001). Interestingly, the combined model (MIF/IL-6/CRP) improved the MIF to predict DCI (AUC of the combined model: 0.811; 95% CI, 0.751-0.871; P = 0.024). Furthermore, inclusion of MIF in the existing risk factors for the prediction of DCI enhanced the index and net reclassification improvement (NRI) (P < 0.001) and integrated discrimination improvement (IDI) (P = 0.005) values, confirming the effective reclassification and discrimination. The data showed that elevated MIF serum level accurately identifies patients at highest risk for developing DCI following aSAH.
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Affiliation(s)
- Xiaobo Yang
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, No 25. Taiping Street, Jiangyang District, Luzhou, 646000, Sichuan Province, China
| | - Jianhua Peng
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, No 25. Taiping Street, Jiangyang District, Luzhou, 646000, Sichuan Province, China
| | - Jinwei Pang
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, No 25. Taiping Street, Jiangyang District, Luzhou, 646000, Sichuan Province, China
| | - Weifeng Wan
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, No 25. Taiping Street, Jiangyang District, Luzhou, 646000, Sichuan Province, China
| | - Chuanhong Zhong
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, No 25. Taiping Street, Jiangyang District, Luzhou, 646000, Sichuan Province, China
| | - Tangming Peng
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, No 25. Taiping Street, Jiangyang District, Luzhou, 646000, Sichuan Province, China
| | - Kunyang Bao
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, No 25. Taiping Street, Jiangyang District, Luzhou, 646000, Sichuan Province, China
| | - Yong Jiang
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, No 25. Taiping Street, Jiangyang District, Luzhou, 646000, Sichuan Province, China.
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Serum levels of Trimethylamine-N-oxide in patients with ischemic stroke. Biosci Rep 2019; 39:BSR20190515. [PMID: 31142624 PMCID: PMC6579976 DOI: 10.1042/bsr20190515] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 05/09/2019] [Accepted: 05/23/2019] [Indexed: 12/31/2022] Open
Abstract
Objective: Accumulating evidence suggests that Trimethylamine-N-oxide (TMAO), a gut microbial metabolite, is implicated in the pathogenesis of many cardiovascular diseases. The aim of the present study was to investigate the serum levels of TMAO in Chinese patients with ischemic stroke. Method: In the present study, 255 consecutive patients with first-ever acute ischemic stroke and 255 age and gender-matched healthy volunteers were included for testing serum TMAO. Stroke severity was determined by the NIH Stroke Scale (NIHSS). The stroke severity was dichotomized as minor (NIHSS ≤ 5) and moderate-to-high clinical severity (NIHSS > 6). Results: The serum levels of TMAO in stroke ranged from 0.5 to 18.3 μM, with a median value of 5.8 (interquartile range (IQR), 3.3–10.0) μM, which was higher than in those controls (3.9; IQR, 2.6–6.1 μM). The median level of TMAO in those patients was significantly lower than in those moderate-to-high stroke patients (4.1 μM [IQR, 2.8–6.2] vs. 9.1 μM [5.1–11.0]; P<0.001). In univariate and multivariable models, the unadjusted risk of moderate-to-high stroke was increased by 31% (odds ratio (OR) = 1.31 [95% confidence interval (CI): 1.21–1.42], P<0.001) and 22% (OR = 1.22; 95% CI = 1.08–1.32; P<0.001), when TMAO was increased each by 1 μM. Based on the receiver operating characteristic (ROC) curve, the optimal cut-off value of serum level of TMAO as an indicator for screening of moderate-to-high stroke was estimated to be 6.6 μM, which yielded a sensitivity of 69.3 % and a specificity of 79.0%, with the area under the curve at 0.750 (95% CI, 0.687–0.812). Conclusions: Higher TMAO levels were associated with increased risk of first ischemic stroke and worse neurological deficit in Chinese patients.
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Prognostic value of copeptin in patients with aneurysmal subarachnoid hemorrhage. J Neuroimmunol 2019; 330:116-122. [PMID: 30875611 DOI: 10.1016/j.jneuroim.2019.03.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 03/06/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND Recently, copeptin has been identified as a plasma prognosis marker in acute ischemic stroke and intracerebral hemorrhage (ICH). This study investigated the prognostic value of copeptin in the patients with aneurysmal subarachnoid hemorrhage(aSAH). METHODS In this retrospective study, 243 consecutive patients were included. Upon admission, plasma copeptin levels were measured by enzyme-linked immunosorbent assay. The end points were mortality and poor functional outcome (Glasgow Outcome Scale score of 1-3) after 3 months. RESULTS In 243 patients, 112 (46.1%) were male and median age was 58 years (IQR 49-68). Median copeptin plasma levels were 21.0 pmol/l (IQR 13.2-31.2). Copeptin levels increased with increasing severity of aSAH as defined by the World Federation of Neurological Surgeons (WFNS) score. Patients with a poor outcome and nonsurvivors had significantly increased copeptin levels on admission (P < .001 both). In the multivariate analysis, for each 1 pmol/l increase of plasma concentration of copeptin, the adjusted risk of poor outcomes and mortality would be increased by and 6% (1.06 [1.02-1.10], P < .001) and 9% (1.09 [1.03-1.13], P < .001), respectively. Receiver operating characteristics to predict functional outcome and mortality demonstrated areas under the curve of copeptin of 0.74 (95% confidence interval [CI], 0.67-0.81) and 0.81 (95% CI, 0.74-0.87), which was comparable with the WFNS score(P > .05) but superior to C-reactive protein and IL-6 (P < .01). CONCLUSIONS The data shows that copeptin levels may reliably predict short-term prognosis at its onset in aSAH patients.
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Liang ZH, Jia YB, Wang ML, Li ZR, Li M, Yun YL, Zhu RX. Efficacy of ginkgo biloba extract as augmentation of venlafaxine in treating post-stroke depression. Neuropsychiatr Dis Treat 2019; 15:2551-2557. [PMID: 31564880 PMCID: PMC6731991 DOI: 10.2147/ndt.s215191] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 07/15/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Post-stroke depression (PSD) is one of the most common psychiatric diseases afflicting stroke survivors. This study was conducted to assess the efficacy of ginkgo biloba extract as augmentation of venlafaxine in treating PSD. METHODS The included PSD patients were randomly assigned into the experiment group (receiving ginkgo biloba extract plus venlafaxine) and control group (receiving venlafaxine alone). The treatment was continued for eight weeks. The Hamilton Depression Rating Scale (HDRS) and the Self-rating Depression Scale (SDS) were used to assess the depressive symptoms. The National Institutes of Health Stroke Scale (NIHSS) was used to assess the neurological defect, and the Activities of Daily Living (ADL) was used to assess recovery of abilities of patients after stroke. Meanwhile, the levels of serum 5-hydroxytryptamine (5-HT) and brain-derived neurotrophic factor (BDNF) were measured before and after treatment. The dose of venlafaxine used and adverse events were also recorded. RESULTS Each group had 40 PSD patients. After treatment, the depressive symptoms, neurological defect and living function were significantly improved in both groups. But the patients receiving ginkgo biloba extract plus venlafaxine had the significantly lower average HDRS score (p=0.0008), SDS score (p<0.00001), NIHSS score (p=0.00001), and higher average ADL score (p=0.0005). Meanwhile, compared to the control group, patients in the experiment group had the significantly higher 5-HT (p<0.00001) level and BDNF level (p<0.00001), needed lower dose of venlafaxine (p=0.007), and experienced fewer adverse events. CONCLUSION These results demonstrated that the ginkgo biloba extract was a good augmentation of venlafaxine in treating PSD and should be further investigated.
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Affiliation(s)
- Zi-Hong Liang
- Department of Neurology, Inner Mongolia Autonomous Region People's Hospital, Huhhot, Inner Mongolia, People's Republic of China
| | - Yan-Bo Jia
- Department of Orthopaedics, The Second Affiliated Hospital of Inner Mongolia Medical University, Huhhot, Inner Mongolia, People's Republic of China
| | - Mei-Ling Wang
- Department of Neurology, Inner Mongolia Autonomous Region People's Hospital, Huhhot, Inner Mongolia, People's Republic of China
| | - Zi-Ru Li
- Department of Neurology, Inner Mongolia Autonomous Region People's Hospital, Huhhot, Inner Mongolia, People's Republic of China
| | - Min Li
- Department of Neurology, Inner Mongolia Autonomous Region People's Hospital, Huhhot, Inner Mongolia, People's Republic of China
| | - Yong-Li Yun
- Department of Neurology, Inner Mongolia Autonomous Region People's Hospital, Huhhot, Inner Mongolia, People's Republic of China
| | - Run-Xiu Zhu
- Department of Neurology, Inner Mongolia Autonomous Region People's Hospital, Huhhot, Inner Mongolia, People's Republic of China
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Lyngbakken MN, Myhre PL, Røsjø H, Omland T. Novel biomarkers of cardiovascular disease: Applications in clinical practice. Crit Rev Clin Lab Sci 2018; 56:33-60. [DOI: 10.1080/10408363.2018.1525335] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Magnus Nakrem Lyngbakken
- Division of Medicine, Akershus University Hospital, Lørenskog, Norway
- Center for Heart Failure Research, University of Oslo, Oslo, Norway
| | - Peder Langeland Myhre
- Division of Medicine, Akershus University Hospital, Lørenskog, Norway
- Center for Heart Failure Research, University of Oslo, Oslo, Norway
| | - Helge Røsjø
- Division of Medicine, Akershus University Hospital, Lørenskog, Norway
- Center for Heart Failure Research, University of Oslo, Oslo, Norway
| | - Torbjørn Omland
- Division of Medicine, Akershus University Hospital, Lørenskog, Norway
- Center for Heart Failure Research, University of Oslo, Oslo, Norway
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Liang X, Liu Y, Jia S, Xu X, Dong M, Wei Y. SIRT1: The Value of Functional Outcome, Stroke-Related Dementia, Anxiety, and Depression in Patients with Acute Ischemic Stroke. J Stroke Cerebrovasc Dis 2018; 28:205-212. [PMID: 30361109 DOI: 10.1016/j.jstrokecerebrovasdis.2018.09.037] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 09/15/2018] [Accepted: 09/23/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The outcome of ischemic stroke depends on multiple factors and their function of each other. Studies have shown that Sirtuin1 (SIRT1) plays a chief role in the key procedure during ischemia/hypoxia by protecting against cellular stress and controlling the metabolic pathways. AIMS To explore the alterations in serum SIRT1 concentrations in acute ischemic stroke (AIS) patients and the relationship between SIRT1 and poststroke dementia, anxiety, and depression. METHODS One hundred and twenty four consecutive patients with clinically diagnosed AIS were recruited to participate in the study. Serum SIRT1 levels were measured using a commercially available ELISA equipment for SIRT1 (Cusabio, Wuhan, China). In 1 year after admission, the severity of stroke was assessed with the National Institutes of Health Stroke Scale score, and the functional outcome was measured by a modified Rankin scale, the Hamilton Anxiety Scale scores were evaluated to define patients with or without anxiety, and the Hamilton Depression Scale scores for depression. RESULTS We found the levels of serum SIRT1 was significantly higher (P = .036) in AIS patients (.62 ± .77 ng/mL) compared with healthy control subjects (.45 ± .69 ng/mL), but not significantly higher SIRT1 concentration (.58 ± .69 versus .64 ± .81 ng/mL, P = .298) than patients in the unfavorable functional outcome group. CONCLUSIONS There is no potential diagnostic and prognostic role of SIRT1 in AIS-related dementia, anxiety, and depression. The role of SIRT1 in AIS among human race needs to be further investigated.
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Affiliation(s)
- Xue Liang
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Neurobiology, Chongqing, China.
| | - Yang Liu
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Neurobiology, Chongqing, China.
| | - Shiyu Jia
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Neurobiology, Chongqing, China.
| | - Xiaomin Xu
- Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.
| | - Meixue Dong
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Neurobiology, Chongqing, China.
| | - Youdong Wei
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Chongqing Key Laboratory of Neurobiology, Chongqing, China.
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Choi HJ, Kim MC, Sim DS, Hong YJ, Kim JH, Jeong MH, Kim SH, Shin MG, Ahn Y. Serum Copeptin Levels Predict Clinical Outcomes After Successful Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction. Ann Lab Med 2018; 38:538-544. [PMID: 30027697 PMCID: PMC6056391 DOI: 10.3343/alm.2018.38.6.538] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 01/16/2018] [Accepted: 05/21/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Serum copeptin has been demonstrated to be useful in early risk stratification and prognostication of patients with acute myocardial infarction (AMI). However, the prognostic value of copeptin after percutaneous coronary intervention (PCI) for clinical outcomes remains uncertain. We investigated the prognostic role of serum copeptin levels immediately after successful PCI as a prognostic marker for major adverse cardiac events (MACE; comprising death, repeat PCI, recurrent MI, or coronary artery bypass grafting) in patients with AMI. METHODS A retrospective study was performed in 149 patients with AMI who successfully received PCI. Serum copeptin levels were analyzed in blood samples collected immediately after PCI. The association between copeptin levels and MACE during the follow-up period was evaluated. RESULTS MACE occurred in 34 (22.8%) patients during a median follow-up of 30.1 months. MACE patients had higher copeptin levels than non-MACE patients did. Multiple logistic regression analysis showed that the increase in serum copeptin levels was associated with increased MACE incidence (odds ratio=1.6, P=0.005). CONCLUSIONS A high level of serum copeptin measured immediately after PCI was associated with MACE in patients with AMI during long-term follow-up. Serum copeptin levels can serve as a prognostic marker in patients with AMI after successful PCI.
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Affiliation(s)
- Hyun Jung Choi
- Departments of Laboratory Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Min Chul Kim
- Department of Cardiology, Cardiovascular Center, Chonnam National University Hospital, Gwangju, Korea
| | - Doo Sun Sim
- Department of Cardiology, Cardiovascular Center, Chonnam National University Hospital, Gwangju, Korea
| | - Young Joon Hong
- Department of Cardiology, Cardiovascular Center, Chonnam National University Hospital, Gwangju, Korea
| | - Ju Han Kim
- Department of Cardiology, Cardiovascular Center, Chonnam National University Hospital, Gwangju, Korea
| | - Myung Ho Jeong
- Department of Cardiology, Cardiovascular Center, Chonnam National University Hospital, Gwangju, Korea
| | - Soo Hyun Kim
- Departments of Laboratory Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Myung Geun Shin
- Departments of Laboratory Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Korea.
| | - Youngkeun Ahn
- Department of Cardiology, Cardiovascular Center, Chonnam National University Hospital, Gwangju, Korea.
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82
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Feng L, Guo J, Ai F. Circulating long noncoding RNA ANRIL downregulation correlates with increased risk, higher disease severity and elevated pro-inflammatory cytokines in patients with acute ischemic stroke. J Clin Lab Anal 2018; 33:e22629. [PMID: 30069916 DOI: 10.1002/jcla.22629] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 07/03/2018] [Accepted: 07/03/2018] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND To investigate the correlation of plasma lncRNA ANRIL expression with stroke risk, severity and inflammatory cytokines levels in acute ischemic stroke (AIS) patients. METHODS A total of 126 AIS patients and 125 controls were consecutively recruited in this case-control study. Blood samples from all participants were collected, and plasma was separated. Plasma lncRNA ANRIL expression was quantified by quantitative real-time polymerase chain reaction (qRT-PCR). Plasma tumor necrosis factor-α (TNF-α) and interleukin (IL)-1β (IL-1β), IL-6, IL-8, IL-10, and IL-17 levels were measured by enzyme-linked immunosorbent assay (ELISA). National Institutes of Health Stroke Scale (NIHSS) scores were used to assess the stroke severity in AIS patients. RESULTS Plasma lncRNA ANRIL expression was lower in AIS patients than in controls (P < 0.001), and the receiver operating characteristic (ROC) curve showed a good prediction value of lncRNA ANRIL for AIS risk with area under curve (AUC) of 0.759 (95% CI: 0.741-0.849). In addition, lncRNA ANRIL expression was negatively correlated with NIHSS score (r = -0.351, P < 0.001). Furthermore, while lncRNA ANRIL expression was negatively associated with hs-CRP level (r = -0.247, P = 0.005), no correlation was found between lncRNA ANRIL expression and ESR level (P = 0.619). For inflammatory cytokines, lncRNA ANRIL expression was inversely associated with TNF-α (r = -0.216, P = 0.015) and IL-6 levels (r = -0.326, P < 0.001), while it positively correlated with IL-10 level (r = 0.210, P = 0.018). CONCLUSION Circulating lncRNA ANRIL downregulation correlates with increased stroke risk, higher disease severity and elevated inflammation in AIS patients.
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Affiliation(s)
- Lijuan Feng
- Department of Emergency, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jun Guo
- Department of Emergency, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fen Ai
- Department of Emergency, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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He MF, Cai WD, Zhao MM, Jiang CH, Qin FZ, Zhou JY, Liang S, Li YY, Wu ZX, Zeng HK. A new algorithm for suspected stroke patient management with NT-proBNP POCT platform in the emergency department: A new algorithm for suspected stroke patient. HONG KONG J EMERG ME 2018. [DOI: 10.1177/1024907917742875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: Stroke is a leading cause of mortality and morbidity in China. Of the different subtypes of ischemic stroke, cardioembolic stroke is of particular importance because it is potentially preventable. This study aimed to evaluate the usefulness of measuring N-terminal pro-brain natriuretic peptide in the emergency department in early recognition of patients with cardioembolic stroke. Methods: This was a multicenter prospective cohort study conducted from 1 June 2015 to 30 June 2016 in four emergency departments. Adult patients with acute ischemic stroke were recruited. Plasma N-terminal pro-brain natriuretic peptide was measured in the emergency department. Discharge diagnosis was determined by neurologists according to the Trial of ORG 10172 in Acute Stroke Treatment criteria. The diagnostic performance of N-terminal pro-brain natriuretic peptide was assessed by measuring the sensitivity, specificity, receiver operating characteristic curve, and the area under curve. Results: In all, 258 patients were analyzed. Of them, 17.9% were diagnosed with cardioembolic stroke. The optimal cut-off concentration, sensitivity, specificity, and the area under the curve of the plasma N-terminal pro-brain natriuretic peptide concentration suitable to distinguish cardioembolic stroke from other subtypes of stroke were 501.2 pg/mL, 82.6%, 80.2%, and 0.87 (95% confidence interval: 0.83–0.92), respectively. Conclusion: Emergency physicians should strongly consider cardioembolic stroke in patients presented with acute ischemic stroke with an N-terminal pro-brain natriuretic peptide level over 501.2 pg/mL. However, it must be considered in context with clinical assessment and judgment before making treatment decisions.
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Affiliation(s)
- Ming-feng He
- Department of Emergency and Critical Care Medicine, Foshan Hospital of Traditional Chinese Medicine, Foshan, China
| | - Wei-dong Cai
- Department of Emergency Medicine, Qingyuan Municipal People’s Hospital, Qingyuan, China
| | - Ming-ming Zhao
- Department of Neurology, Jiangbin Hospital, Guangxi Zhuang Autonomous Region, Nanning, China
| | - Chong-hui Jiang
- Department of Emergency Medicine, Zhongshan People’s Hospital, Zhongshan, China
| | - Feng-zhou Qin
- Department of Emergency and Critical Care Medicine, Foshan Hospital of Traditional Chinese Medicine, Foshan, China
| | - Jian-yi Zhou
- Department of Emergency and Critical Care Medicine, Foshan Hospital of Traditional Chinese Medicine, Foshan, China
| | - Sina Liang
- Department of Emergency and Critical Care Medicine, Foshan Hospital of Traditional Chinese Medicine, Foshan, China
| | - Ying-ying Li
- Department of Emergency and Critical Care Medicine, Foshan Hospital of Traditional Chinese Medicine, Foshan, China
| | - Zhi-xin Wu
- Department of Emergency and Critical Care Medicine, Foshan Hospital of Traditional Chinese Medicine, Foshan, China
| | - Hong-ke Zeng
- Department of Critical Care and Emergency, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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84
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Li YY, Wang YS, Chen Y, Hu YH, Cui W, Shi XY, Jiang W, Zhang JM. Association of Serum 25(OH) D Levels with Infarct Volumes and Stroke Severity in Acute Ischemic Stroke. J Nutr Health Aging 2018; 22:97-102. [PMID: 29300428 DOI: 10.1007/s12603-017-0926-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND The aim of this study is to investigate whether 25-hydroxyvitamin D [25(OH) D] is associated with initial stroke severity and infarct volume, using diffusion-weighted imaging (DWI) in patients with acute ischemic stroke. METHODS We studied a total of 235 patients who were admitted within 24 hours of acute ischemic stroke onset. Initial stroke severity was assessed using the NIH Stroke Scale (NIHSS) score. Infarct volume was measured using DWI. Multivariable linear and logistic regression analyses were used to test whether 25(OH) D represents an independent predictor of infarct volume and stroke severity (NIHSS score of ≥6). RESULTS Among 235 study patients, the median age was 64 years (IQR 56-75 years), and 125 (53.2%) were women. In multivariable models adjusted for other significant risk factors, 25(OH) D levels in the lowest and second interquartiles were associated with an increased risk of a NIHSS≥6 (with highest 25 (OH) D quartile as reference) with odd ratios (OR) 3.02(95% confidence interval [CI]:1.59-6.34) and 5.85(2.90-11.54). The median DWI infarct volumes for the serum 25(OH) D level quartiles (lowest to highest) were 12.35, 6.55, 2.44, and 1.59 ml. The median DWI infarct volume in the lowest serum 25(OH) D level quartile was larger than that in the other 3 quartiles (P<0.001). The median adjusted DWI infarct volume in the lowest serum 25(OH) D level quartile was statistically significantly larger than that in the other 3 quartiles (P<0.01). CONCLUSION In conclusion, reduced serum 25(OH) D levels in acute ischemic stroke are an early predictor of larger volumes of ischemic tissue and worse neurological deficit (assessed by the NIHSS).
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Affiliation(s)
- Y Y Li
- Jian-min Zhang, No. 88, Jiefang Road, Hangzhou, 310009, Zhejiang province, China, , Tel/Fax: 86-0571-87783777
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85
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Zhu M, Li N, Luo P, Jing W, Wen X, Liang C, Tu J. Peripheral Blood Leukocyte Expression of lncRNA MIAT and Its Diagnostic and Prognostic Value in Ischemic Stroke. J Stroke Cerebrovasc Dis 2017; 27:326-337. [PMID: 29030044 DOI: 10.1016/j.jstrokecerebrovasdis.2017.09.009] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 08/29/2017] [Accepted: 09/06/2017] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Ischemic stroke (IS) is an extremely heterogeneous disease with variable pathogenesis. Due to the lack of early diagnostic markers, the mortality rate of IS remains high. Cumulative evidence shows that long noncoding RNAs among noncoding RNAs play important roles in cardiovascular diseases. In the present study, we focused on the expression pattern of myocardial infarction-associated transcript (MIAT) and its clinical significance in IS. METHODS Blood samples were obtained from IS patients (n = 189) and healthy controls (n = 189). The National Institutes of Health Stroke Scale (NIHSS) was measured at the time of admission. Short-term functional outcome was measured by the modified Rankin Scale (mRS) at 3 months after admission. Multivariate analyses were performed using logistic regression models. The receiver operating characteristic (ROC) curve was used to evaluate the accuracy of MIAT in the diagnosis and prognosis of IS. RESULTS In IS patients, MIAT expression level was significantly upregulated and correlated with NIHSS scores (r = .421, P <.001), mRS (r = .339, P <.001), high-sensitivity C-reactive protein (r = .309, P <.001), and infarct volume (r = .318, P <.001). ROC curves indicated that MIAT could serve as a potential marker for discriminating IS patients from the controls with an area under the curve of .842 (95% confidence interval, .802-.881). The overall survival analysis showed that patients with higher MIAT expression had a relatively poor prognosis. Meanwhile, the multivariate analysis revealed that MIAT was an independent prognostic marker of functional outcome and death in patients with IS. CONCLUSION Our data suggested that MIAT might be a potential diagnostic and prognostic indicator in IS.
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Affiliation(s)
- Man Zhu
- Department of Clinical Laboratory & Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Nandi Li
- Department of Clinical Laboratory & Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Ping Luo
- Department of Clinical Laboratory & Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Wei Jing
- Department of Clinical Laboratory & Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xue Wen
- Department of Clinical Laboratory & Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Chunzi Liang
- Department of Clinical Laboratory & Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jiancheng Tu
- Department of Clinical Laboratory & Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University, Wuhan, China.
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86
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Chang L, Zhang J, Liu L, Huang Z, Han Y, Zhu Y. Fatty acid binding protein 4 is associated with stroke risk and severity in patients with acute ischemic stroke. J Neuroimmunol 2017; 311:29-34. [PMID: 28781090 DOI: 10.1016/j.jneuroim.2017.07.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Revised: 07/13/2017] [Accepted: 07/18/2017] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The role of fatty acid-binding proteins (FABPs) in atherosclerosis has been investigated. The aim of this study was to verify the hypothesis that higher levels of serum FABP4 could be a biomarker for stroke and associated with stroke severity in Chinese patients with ischemic stroke. METHODS All consecutive patients with first-ever acute ischemic stroke from September 2015 to August 2016 were recruited to participate in the study. Serum FABP4 levels and routine tests were examined at admission. The National Institutes of Health Stroke Scale (NIHSS) score was assessed on admission blinded to FABP4 levels. RESULTS We recorded 277 stroke patients. There was a significant difference in median serum FABP4 levels between stroke patients and control cases (P<0.001). Serum FABP4 levels increased with increasing severity of stroke as defined by the NIHSS score. The result illustrates the time course of serum FABP4, showing significant changes with day of sampling, with peak levels on day 1, falling to a plateau by days 2 to 5. At admission, 129 patients (46.6%) had a minor stroke (NIHSS≤5). In these patients, the median serum FABP4 level was lower than that observed in patients with moderate-to-sever clinical severity (P<0.001). In multivariate models comparing the second, third, and fourth quartiles against the first quartile of the FABP4, levels of FABP4 were associated with stroke risk and severity. CONCLUSION High levels of FABP4 are significantly related to stroke risk and severity, independent from other traditional and emerging risk factors, suggesting that they may play a role in stroke pathogenesis.
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Affiliation(s)
- Li Chang
- Department of Neurology, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China.
| | - Jianlong Zhang
- Department of Neurology, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Li Liu
- Department of Neurology, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Zhen Huang
- Department of Neurology, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Yingbo Han
- Department of Neurology, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Yanyan Zhu
- Department of Neurology, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
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Tang WZ, Wang XB, Li HT, Dong M, Ji X. Serum Copeptin Predicts Severity and Recurrent Stroke in Ischemic Stroke Patients. Neurotox Res 2017; 32:420-425. [PMID: 28555260 DOI: 10.1007/s12640-017-9754-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 05/09/2017] [Accepted: 05/16/2017] [Indexed: 11/25/2022]
Abstract
Several studies investigated the prognostic role of copeptin in stroke. The aim of this study is to assess copeptin levels in serum, and investigate their associations with risk of recurrent stroke in a 1-year follow-up study in patients with ischemic stroke. In this post hoc analysis, serum levels of copeptin and NIH stroke scale (NIHSS) were measured at the time of admission in a cohort of 316 patients with ischemic stroke. The end point was stroke recurrence after 1-year follow-up. We used logistic regression model to assess the relationship between copeptin levels and risk recurrent stroke. Logistic regression analysis considering traditional risk factors showed a relationship between serum copeptin levels and moderate-to-high clinical severity when serum copeptin was used as a continuous variable (OR, 1.05; 95% CI, 1.03-1.09). In the follow-up, 54 patients (17.1%) had a stroke recurrence. The stroke recurrence events distribution across the copeptin quartiles ranged between 5.1% (first quartile) to 23.1% (fourth quartile). In multivariate models comparing the third (OR = 2.78; 95% CI 1.85-3.53) and fourth quartiles (OR = 4.00; 95% CI 2.86-6.50) against the first quartile of the copeptin, levels of copeptin were associated with stroke recurrence events. A higher serum copeptin level is a predictor of both severity at admission and stroke recurrence at 1-year in stroke patients.
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Affiliation(s)
- Wan-Zhong Tang
- Department of Neurosurgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiao-Bo Wang
- Department of Geriatrics and Shandong Key Laboratory of Proteomics, Qilu Hospital of Shandong University, 107 Wenhuaxi, Road, Jinan, Shandong Province, 250012, China
| | - Huan-Ting Li
- Department of Neurosurgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Mei Dong
- Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Xiang Ji
- Department of Geriatrics and Shandong Key Laboratory of Proteomics, Qilu Hospital of Shandong University, 107 Wenhuaxi, Road, Jinan, Shandong Province, 250012, China.
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Sinawang PD, Harpaz D, Fajs L, Seet RCS, Tok AIY, Marks RS. Electrochemical impedimetric detection of stroke biomarker NT-proBNP using disposable screen-printed gold electrodes. EUROBIOTECH JOURNAL 2017. [DOI: 10.24190/issn2564-615x/2017/02.09] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Abstract
Stroke is the second top leading cause of death globally. It is caused by an abrupt interruption of blood flow to the brain. In that course, brain natriuretic peptide (BNP) and its derivative N-terminal pro b-type natriuretic peptide (NT-proBNP), neurohormones produced mainly by the heart ventricles in response to excessive stretching of cardiomyocytes (heart muscle cells), are proven to be good biomarkers for heart failure diagnosis. Moreover, there is growing clinical interest of the use of NT-proBNP for stroke diagnosis and prognosis because it is significantly associated with cardioembolic stroke and secondary stroke reoccurrence, with sensitivity >90% and specificity >80%. However, in diagnostic settings, there is still a need to address the encountered analytical problems, particularly assay specificity and set up. In this study, a novel approach for NT-proBNP detection is demonstrated using an electrochemical immunoassay method. A label-free impedimetry immunosensor for stroke biomarker was developed using modified disposable screen-printed gold electrodes (SPGE) hosting specific anti-NT-proBNP capture antibody. The performance of our immunosensor was studied in the presence of NT-proBNP in both buffered and mock (porcine) plasma samples. A linear relation between the relative total resistance (ΔRtot) responses and the NT-proBNP concentrations in buffer was observed in a range from 0.1 to 5 ng mL-1 with a correlation coefficient (R2) of 0.94656. Overall, the biosensor has demonstrated the capability to quantitate NT-proBNP and differentiate such concentrations in a low concentration range, especially among 0, 0.1, 0.5, 1, and 3 ng mL-1 in plasma samples within 25 min. This range is valuable not only for classifying cardioembolic stroke (higher or equal to 0.5 ng mL-1), but also predicting the risk of secondary stroke reoccurrence (higher than 0.255 ng mL-1). Our biosensor has the potential to be used as an easy-to-use point-of-care test that is both accurate and affordable.
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Affiliation(s)
- Prima Dewi Sinawang
- School of Materials Science and Engineering, Nanyang Technological University, Singapore
- Biosensorix Pte. Ltd., 1 Raffles Place, Singapore 048616, Singapore
| | - Dorin Harpaz
- School of Materials Science and Engineering, Nanyang Technological University, Singapore
- The Avram and Stella Goldstein-Goren Department of Biotechnology Engineering, Ben-Gurion University of the Negev , Israel
- Institute for Sports Research, Nanyang Technological University, Singapore
| | - Luka Fajs
- School of Materials Science and Engineering, Nanyang Technological University, Singapore
- Biosensorix Pte. Ltd., 1 Raffles Place, Singapore 048616, Singapore
| | - Raymond Chee Seong Seet
- Division of Neurology, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore , Singapore
| | - Alfred Iing Yoong Tok
- School of Materials Science and Engineering, Nanyang Technological University, Singapore
- Institute for Sports Research, Nanyang Technological University, Singapore
| | - Robert S. Marks
- School of Materials Science and Engineering, Nanyang Technological University, Singapore
- The Avram and Stella Goldstein-Goren Department of Biotechnology Engineering, Ben-Gurion University of the Negev , Israel
- The National Institute for Biotechnology, The Ilse Katz Center for Meso and Nanoscale Science and Technology, Ben-Gurion University of the Negev , Israel
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Tu WJ, Zeng XW, Deng A, Zhao SJ, Luo DZ, Ma GZ, Wang H, Liu Q. Circulating FABP4 (Fatty Acid-Binding Protein 4) Is a Novel Prognostic Biomarker in Patients With Acute Ischemic Stroke. Stroke 2017; 48:1531-1538. [PMID: 28487339 DOI: 10.1161/strokeaha.117.017128] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 04/04/2017] [Accepted: 04/10/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND PURPOSE FABP4 (fatty acid-binding protein 4) is an intracellular lipid chaperone involved in coordination of lipid transportation and atherogenesis. This study aimed at observing the effect of FABP4 on the 3-month outcomes in Chinese patients with acute ischemic stroke. METHODS In a prospective multicenter observational study, serum concentrations of FABP4 were on admission measured in plasma of 737 consecutive patients with acute ischemic stroke. Serum concentrations of FABP4, National Institutes of Health Stroke Scale score, and conventional risk factors were evaluated to determine their value to predict functional outcome and mortality within 3 months. RESULTS During follow-up, an unfavorable functional outcome was found in 260 patients (35.3%), and 94 patients (12.8%) died. In multivariate models comparing the third and fourth quartiles to the first quartile of FABP4, the concentrations of FABP4 were associated with poor functional outcome and mortality. Compared with the reference category (Q1-Q3), the concentrations of FABP4 in Q4 had a relative risk of 4.77 (95% confidence interval [CI], 2.02-8.15; P<0.001) for poor functional outcome and mortality (odds ratio, 6.15; 95% CI, 3.43-12.68) after adjusting for other significant outcome predictors in univariate logistic regression analysis. Receiver-operating characteristic curves to predict poor functional outcome and mortality demonstrated areas under the curve of FABP4 of 0.78 (95% CI, 0.75-0.82) and 0.83 (95% CI, 0.79-0.88), which improved the prognostic accuracy of National Institutes of Health Stroke Scale score with combined areas under the curve of 0.83 (95% CI, 0.76-0.89; P<0.01) and 0.86 (95% CI, 0.81-0.92), respectively. CONCLUSIONS Data show that FABP4 is a novel independent prognostic marker improving the currently used risk stratification of stroke patients.
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Affiliation(s)
- Wen-Jun Tu
- From the Institute of Radiation Medicine, China Academy of Medical Science and Peking Union Medical College, Tianjin, China (W.-J.T., Q.L.); Department of Neurology, China Rehabilitation Research Center, Beijing, China (W.-J.T., S.-J.Z.); School of Rehabilitation Medicine, Capital Medical University, Beijing, China (W.-J.T., H.W.); Department of Neurosurgery, Affiliated Hospital of Weifang Medical University, China (X.-W.Z., A.D.); and Department of Neurology, Provincial Hospital of Shandong University, Jinan, China (D.-Z.L., G.-Z.M.)
| | - Xian-Wei Zeng
- From the Institute of Radiation Medicine, China Academy of Medical Science and Peking Union Medical College, Tianjin, China (W.-J.T., Q.L.); Department of Neurology, China Rehabilitation Research Center, Beijing, China (W.-J.T., S.-J.Z.); School of Rehabilitation Medicine, Capital Medical University, Beijing, China (W.-J.T., H.W.); Department of Neurosurgery, Affiliated Hospital of Weifang Medical University, China (X.-W.Z., A.D.); and Department of Neurology, Provincial Hospital of Shandong University, Jinan, China (D.-Z.L., G.-Z.M.)
| | - Aijun Deng
- From the Institute of Radiation Medicine, China Academy of Medical Science and Peking Union Medical College, Tianjin, China (W.-J.T., Q.L.); Department of Neurology, China Rehabilitation Research Center, Beijing, China (W.-J.T., S.-J.Z.); School of Rehabilitation Medicine, Capital Medical University, Beijing, China (W.-J.T., H.W.); Department of Neurosurgery, Affiliated Hospital of Weifang Medical University, China (X.-W.Z., A.D.); and Department of Neurology, Provincial Hospital of Shandong University, Jinan, China (D.-Z.L., G.-Z.M.)
| | - Sheng-Jie Zhao
- From the Institute of Radiation Medicine, China Academy of Medical Science and Peking Union Medical College, Tianjin, China (W.-J.T., Q.L.); Department of Neurology, China Rehabilitation Research Center, Beijing, China (W.-J.T., S.-J.Z.); School of Rehabilitation Medicine, Capital Medical University, Beijing, China (W.-J.T., H.W.); Department of Neurosurgery, Affiliated Hospital of Weifang Medical University, China (X.-W.Z., A.D.); and Department of Neurology, Provincial Hospital of Shandong University, Jinan, China (D.-Z.L., G.-Z.M.)
| | - Ding-Zhen Luo
- From the Institute of Radiation Medicine, China Academy of Medical Science and Peking Union Medical College, Tianjin, China (W.-J.T., Q.L.); Department of Neurology, China Rehabilitation Research Center, Beijing, China (W.-J.T., S.-J.Z.); School of Rehabilitation Medicine, Capital Medical University, Beijing, China (W.-J.T., H.W.); Department of Neurosurgery, Affiliated Hospital of Weifang Medical University, China (X.-W.Z., A.D.); and Department of Neurology, Provincial Hospital of Shandong University, Jinan, China (D.-Z.L., G.-Z.M.)
| | - Guo-Zhao Ma
- From the Institute of Radiation Medicine, China Academy of Medical Science and Peking Union Medical College, Tianjin, China (W.-J.T., Q.L.); Department of Neurology, China Rehabilitation Research Center, Beijing, China (W.-J.T., S.-J.Z.); School of Rehabilitation Medicine, Capital Medical University, Beijing, China (W.-J.T., H.W.); Department of Neurosurgery, Affiliated Hospital of Weifang Medical University, China (X.-W.Z., A.D.); and Department of Neurology, Provincial Hospital of Shandong University, Jinan, China (D.-Z.L., G.-Z.M.)
| | - Hong Wang
- From the Institute of Radiation Medicine, China Academy of Medical Science and Peking Union Medical College, Tianjin, China (W.-J.T., Q.L.); Department of Neurology, China Rehabilitation Research Center, Beijing, China (W.-J.T., S.-J.Z.); School of Rehabilitation Medicine, Capital Medical University, Beijing, China (W.-J.T., H.W.); Department of Neurosurgery, Affiliated Hospital of Weifang Medical University, China (X.-W.Z., A.D.); and Department of Neurology, Provincial Hospital of Shandong University, Jinan, China (D.-Z.L., G.-Z.M.)
| | - Qiang Liu
- From the Institute of Radiation Medicine, China Academy of Medical Science and Peking Union Medical College, Tianjin, China (W.-J.T., Q.L.); Department of Neurology, China Rehabilitation Research Center, Beijing, China (W.-J.T., S.-J.Z.); School of Rehabilitation Medicine, Capital Medical University, Beijing, China (W.-J.T., H.W.); Department of Neurosurgery, Affiliated Hospital of Weifang Medical University, China (X.-W.Z., A.D.); and Department of Neurology, Provincial Hospital of Shandong University, Jinan, China (D.-Z.L., G.-Z.M.).
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90
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Zhang W, Zhang XA. A Novel Urinary Metabolite Signature for Non-invasive Post-stroke Depression Diagnosis. Cell Biochem Biophys 2017; 72:661-7. [PMID: 27352185 DOI: 10.1007/s12013-014-0472-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Post-stroke depression (PSD) is the most common psychiatric complication in stroke survivors that has been associated with increased physical disability, distress, poor rehabilitation, and suicidal ideation. However, there are still no biomarkers available to support objective laboratory testing for this disorder. Here, a GC-MS-based urinary metabolomics approach was used to characterize the urinary metabolic profiling of PSD (stroke) subjects and non-PSD (health controls) subjects in order to identify and validate urinary metabolite biomarkers for PSD. Six metabolites, azelaic acid, glyceric acid, pseudouridine, 5-hydroxyhexanoic acid, tyrosine, and phenylalanine, were defined as biomarkers. A combined panel of these six urinary metabolites could effectively discriminate between PSD subjects and non-PSD subjects, achieving an area under the receiver-operating characteristic curve (AUC) of 0.961 in a training set (n = 72 PSD subjects and n = 146 non-PSD subjects). Moreover, this urinary biomarker panel was capable of discriminating blinded test samples (n = 58 PSD patients and n = 109 non-PSD subjects) with an AUC of 0.954. These findings suggest that a urine-based laboratory test using these biomarkers may be useful in the diagnosis of PSD.
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Affiliation(s)
- Wei Zhang
- Department of Neurology, Shengjing Hospital of China Medical University, Shenyang No. 36, Sanhao Street, Heping District, Shenyang, 110004, People's Republic of China.
| | - Xin-An Zhang
- School of Kinesiology, Shenyang Sport University, Shenyang, 110102, People's Republic of China
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91
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Niu Z, Hu H, Tang F. High Free Fatty Acid Levels Are Associated with Stroke Recurrence and Poor Functional Outcome in Chinese Patients with Ischemic Stroke. J Nutr Health Aging 2017; 21:1102-1106. [PMID: 29188867 DOI: 10.1007/s12603-016-0852-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND The aim of this study is to investigate whether serum and cerebrospinal fluid (CSF) free fatty acid (FFA) levels are associated with outcome and recurrence in a cohort of patients with an acute ischemic stroke (AIS). METHODS From December 2013 to May 2015, patients with first-ever AIS were included. FFA level and NIH stroke scale (NIHSS) were measured at the time of admission. Logistic regression analysis was used to evaluate the stroke outcome and recurrence according to FFA level. Clinical follow-up was performed at 6 month. RESULTS In our study, we studied 296 patients (52.7% male). We have found a positive correlation between serum and CSF levels of FFA. Patients with a poor outcome and recurrence had significantly increased FFA serum and CSF levels on admission (all p<0.0001). Multivariate logistic regression analysis adjusted for common risk factors showed that FFA was an independent predictor of poor functional outcome and recurrence. Odds ratios (OR) values were more significant for the higher levels of FFA. CONCLUSION In summary, baseline serum and CSF FFA level were associated with stroke poor function outcome and recurrence, suggesting an effect of FFA on disease course in AIS.
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Affiliation(s)
- Z Niu
- Fengyun Tang, Department of neurology, Shaoxing center Hospital, No.1, huayu Road Shaoxing, 312030, China, E-mail: ; Tel: 86- 15857597397
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92
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Xu Q, Tian Y, Peng H, Li H. Copeptin as a biomarker for prediction of prognosis of acute ischemic stroke and transient ischemic attack: a meta-analysis. Hypertens Res 2016; 40:465-471. [DOI: 10.1038/hr.2016.165] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 08/25/2016] [Accepted: 08/28/2016] [Indexed: 11/09/2022]
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93
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Wang J, Gao L, Yang YL, Li YQ, Chang T, Man MH, Zhang XY, Guo SC, Li LH. Low Serum Levels of Brain-Derived Neurotrophic Factor Were Associated with Poor Short-Term Functional Outcome and Mortality in Acute Ischemic Stroke. Mol Neurobiol 2016; 54:7335-7342. [DOI: 10.1007/s12035-016-0236-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 10/17/2016] [Indexed: 11/28/2022]
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94
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Wang CB, Zong M, Lu SQ, Tian Z. Plasma copeptin and functional outcome in patients with ischemic stroke and type 2 diabetes. J Diabetes Complications 2016; 30:1532-1536. [PMID: 27554438 DOI: 10.1016/j.jdiacomp.2016.07.030] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Revised: 06/13/2016] [Accepted: 07/26/2016] [Indexed: 11/22/2022]
Abstract
BACKGROUND The activation of the arginine vasopressin system may be involved in the pathology of stroke and diabetes. In this study, we therefore evaluated the short-term prognostic value of early measurement of plasma copeptin levels in Chinese patients with type 2 diabetes mellitus (T2DM) and acute ischemic stroke (AIS). METHODS From July 2014 to June 2015, all T2DM patients with first-ever AIS were included. Plasma levels of copeptin were tested at admission. The prognostic value of copeptin to predict the functional outcome and mortality 3months after stroke was compared with the National Institutes of Health Stroke Scale score and with other known outcome predictors. RESULTS We recorded 247 stroke patients with T2DM. The copeptin levels were obtained in those patients with a median value of 14.3pmol/L (IQR, 9.5-17.1pmol/L). At 3-month follow-up, a favorable functional outcome was found in 86 patients (34.8%). Plasma copeptin levels in patients with an unfavorable outcome were significantly greater than those in patients with a favorable outcome (16.2 [IQR, 12.2-20.3] vs. 12.4 [IQR, 8.6-15.2] pmol/L; Z=5.399; P<0.0001). In univariate logistic regression analysis, with an unadjusted OR of 1.123 (95% CI, 1.072-1.177, P<0.001), copeptin had a strong association with unfavorable functional outcome. In multivariate analyses, a copeptin level in the highest inter-quartile (>17.1pmol/L) was associated with a higher risk of unfavorable functional outcome (OR=4.62; 95% CI=2.63-9.21; P<0.001). After adjusting for other outcome predictors, a copeptin level in the highest inter-quartile (>17.1pmol/L) was associated with a higher risk of mortality (OR=5.12; 95% CI=2.20-11.38; P<0.001). CONCLUSION Our study suggested that copeptin levels may reliably predict short-term stroke prognosis at its onset in Chinese patients with T2DM and stroke.
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Affiliation(s)
- Chi-Bo Wang
- Department of Neurosurgery, Yantaishan Hospital, Yantai, China
| | - Miao Zong
- Department of Neurosurgery, Beijing Electric Power Hospital of the Capital Medical University, Beijing, China
| | - Shi-Qing Lu
- Department of Neurosurgery, Yantaishan Hospital, Yantai, China
| | - Zhuo Tian
- Department of Neurosurgery, Yantai Hospital of Tradition Chinese Medicine, Yantai, China.
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95
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Bustamante A, Simats A, Vilar-Bergua A, García-Berrocoso T, Montaner J. Blood/Brain Biomarkers of Inflammation After Stroke and Their Association With Outcome: From C-Reactive Protein to Damage-Associated Molecular Patterns. Neurotherapeutics 2016; 13:671-684. [PMID: 27538777 PMCID: PMC5081112 DOI: 10.1007/s13311-016-0470-2] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Stroke represents one of the most important causes of disability and death in developed countries. However, there is a lack of prognostic tools in clinical practice to monitor the neurological condition and predict the final outcome. Blood biomarkers have been proposed and studied in this indication; however, no biomarker is currently used in clinical practice. The stroke-related neuroinflammatory processes have been associated with a poor outcome in stroke, as well as with poststroke complications. In this review, we focus on the most studied blood biomarkers of this inflammatory processes, cytokines, and C-reactive protein, evaluating its association with outcome and complications in stroke through the literature, and performing a systematic review on the association of C-reactive protein and functional outcome after stroke. Globally, we identified uncertainty with regard to the association of the evaluated biomarkers with stroke outcome, with little added value on top of clinical predictors such as age or stroke severity, which makes its implementation unlikely in clinical practice for global outcome prediction. Regarding poststroke complications, despite being more practical scenarios in which to make medical decisions following a biomarker prediction, not many studies have been performed, although there are now some candidates for prediction of poststroke infections. Finally, as potential new candidates, we reviewed the pathophysiological actions of damage-associated molecular patterns as triggers of the neuroinflammatory cascade of stroke, and their possible use as biomarkers.
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Affiliation(s)
- Alejandro Bustamante
- Neurovascular Research Laboratory, Institut de Recerca, Hospital Universitari Vall d'Hebron (VHIR), Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Alba Simats
- Neurovascular Research Laboratory, Institut de Recerca, Hospital Universitari Vall d'Hebron (VHIR), Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Andrea Vilar-Bergua
- Neurovascular Research Laboratory, Institut de Recerca, Hospital Universitari Vall d'Hebron (VHIR), Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Teresa García-Berrocoso
- Neurovascular Research Laboratory, Institut de Recerca, Hospital Universitari Vall d'Hebron (VHIR), Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Joan Montaner
- Neurovascular Research Laboratory, Institut de Recerca, Hospital Universitari Vall d'Hebron (VHIR), Universitat Autónoma de Barcelona, Barcelona, Spain.
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96
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Xiao J, Zhang J, Sun D, Wang L, Yu L, Wu H, Wang D, Qiu X. Discriminating poststroke depression from stroke by nuclear magnetic resonance spectroscopy-based metabonomic analysis. Neuropsychiatr Dis Treat 2016; 12:1919-25. [PMID: 27536114 PMCID: PMC4977099 DOI: 10.2147/ndt.s110613] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Poststroke depression (PSD), the most common psychiatric disease that stroke survivors face, is estimated to affect ~30% of poststroke patients. However, there are still no objective methods to diagnose PSD. In this study, to explore the differential metabolites in the urine of PSD subjects and to identify a potential biomarker panel for PSD diagnosis, the nuclear magnetic resonance-based metabonomic method was applied. Ten differential metabolites responsible for discriminating PSD subjects from healthy control (HC) and stroke subjects were found, and five of these metabolites were identified as potential biomarkers (lactate, α-hydroxybutyrate, phenylalanine, formate, and arabinitol). The panel consisting of these five metabolites provided excellent performance in discriminating PSD subjects from HC and stroke subjects, achieving an area under the receiver operating characteristic curve of 0.946 in the training set (43 HC, 45 stroke, and 62 PSD subjects). Moreover, this panel could classify the blinded samples from the test set (31 HC, 33 stroke, and 32 PSD subjects) with an area under the curve of 0.946. These results laid a foundation for the future development of urine-based objective methods for PSD diagnosis and investigation of PSD pathogenesis.
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Affiliation(s)
- Jianqi Xiao
- Department of Neurosurgery, The First Hospital of Qiqihar City, Qiqihar
| | - Jie Zhang
- Department of Internal Medicine, Central Hospital of Jiamusi City, Jiamusi
| | - Dan Sun
- Department of Geriatrics, General Hospital of Daqing Oil Field, Daqing
| | | | - Lijun Yu
- Department of Neurology, The First Hospital of Qiqihar City, Qiqihar, Heilongjiang, People’s Republic of China
| | - Hongjing Wu
- Department of Neurology, The First Hospital of Qiqihar City, Qiqihar, Heilongjiang, People’s Republic of China
| | - Dan Wang
- Department of Neurology, The First Hospital of Qiqihar City, Qiqihar, Heilongjiang, People’s Republic of China
| | - Xuerong Qiu
- Department of Neurology, The First Hospital of Qiqihar City, Qiqihar, Heilongjiang, People’s Republic of China
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97
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Ma L, Zhu D, Jiang Y, Liu Y, Ma X, Liu M, Chen X. Low triiodothyronine: A new facet of inflammation in acute ischemic stroke. Clin Chim Acta 2016; 458:63-7. [DOI: 10.1016/j.cca.2016.04.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 04/15/2016] [Accepted: 04/20/2016] [Indexed: 01/17/2023]
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98
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Barra de la Tremblaye P, Plamondon H. Alterations in the corticotropin-releasing hormone (CRH) neurocircuitry: Insights into post stroke functional impairments. Front Neuroendocrinol 2016; 42:53-75. [PMID: 27455847 DOI: 10.1016/j.yfrne.2016.07.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 07/04/2016] [Accepted: 07/06/2016] [Indexed: 10/21/2022]
Abstract
Although it is well accepted that changes in the regulation of the hypothalamic-pituitary adrenal (HPA) axis may increase susceptibility to affective disorders in the general population, this link has been less examined in stroke patients. Yet, the bidirectional association between depression and cardiovascular disease is strong, and stress increases vulnerability to stroke. Corticotropin-releasing hormone (CRH) is the central stress hormone of the HPA axis pathway and acts by binding to CRH receptors (CRHR) 1 and 2, which are located in several stress-related brain regions. Evidence from clinical and animal studies suggests a role for CRH in the neurobiological basis of depression and ischemic brain injury. Given its importance in the regulation of the neuroendocrine, autonomic, and behavioral correlates of adaptation and maladaptation to stress, CRH is likely associated in the pathophysiology of post stroke emotional impairments. The goals of this review article are to examine the clinical and experimental data describing (1) that CRH regulates the molecular signaling brain circuit underlying anxiety- and depression-like behaviors, (2) the influence of CRH and other stress markers in the pathophysiology of post stroke emotional and cognitive impairments, and (3) context and site specific interactions of CRH and BDNF as a basis for the development of novel therapeutic targets. This review addresses how the production and release of the neuropeptide CRH within the various regions of the mesocorticolimbic system influences emotional and cognitive behaviors with a look into its role in psychiatric disorders post stroke.
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Affiliation(s)
- P Barra de la Tremblaye
- School of Psychology, Behavioral Neuroscience Program, University of Ottawa, 136 Jean-Jacques Lussier, Vanier Building, Ottawa, Ontario K1N 6N5, Canada
| | - H Plamondon
- School of Psychology, Behavioral Neuroscience Program, University of Ottawa, 136 Jean-Jacques Lussier, Vanier Building, Ottawa, Ontario K1N 6N5, Canada.
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99
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Maestrini I, Ducroquet A, Moulin S, Leys D, Cordonnier C, Bordet R. Blood biomarkers in the early stage of cerebral ischemia. Rev Neurol (Paris) 2016; 172:198-219. [PMID: 26988891 DOI: 10.1016/j.neurol.2016.02.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 12/29/2015] [Indexed: 01/25/2023]
Abstract
In ischemic stroke patients, blood-based biomarkers may be applied for the diagnosis of ischemic origin and subtype, prediction of outcomes and targeted treatment in selected patients. Knowledge of the pathophysiology of cerebral ischemia has led to the evaluation of proteins, neurotransmitters, nucleic acids and lipids as potential biomarkers. The present report focuses on the role of blood-based biomarkers in the early stage of ischemic stroke-within 72h of its onset-as gleaned from studies published in English in such patients. Despite growing interest in their potential role in clinical practice, the application of biomarkers for the management of cerebral ischemia is not currently recommended by guidelines. However, there are some promising clinical biomarkers, as well as the N-methyl-d-aspartate (NMDA) peptide and NMDA-receptor (R) autoantibodies that appear to identify the ischemic nature of stroke, and the glial fibrillary acidic protein (GFAP) that might be able to discriminate between acute ischemic and hemorrhagic strokes. Moreover, genomics and proteomics allow the characterization of differences in gene expression, and protein and metabolite production, in ischemic stroke patients compared with controls and, thus, may help to identify novel markers with sufficient sensitivity and specificity. Additional studies to validate promising biomarkers and to identify novel biomarkers are needed.
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Affiliation(s)
- I Maestrini
- Inserm U 1171, Department of Neurology, University of Lille, UDSL, CHU Lille, 59000 Lille, France
| | - A Ducroquet
- Inserm U 1171, Department of Neurology, University of Lille, UDSL, CHU Lille, 59000 Lille, France
| | - S Moulin
- Inserm U 1171, Department of Neurology, University of Lille, UDSL, CHU Lille, 59000 Lille, France
| | - D Leys
- Inserm U 1171, Department of Neurology, University of Lille, UDSL, CHU Lille, 59000 Lille, France.
| | - C Cordonnier
- Inserm U 1171, Department of Neurology, University of Lille, UDSL, CHU Lille, 59000 Lille, France
| | - R Bordet
- Inserm U 1171, Department of Neurology, University of Lille, UDSL, CHU Lille, 59000 Lille, France
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100
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Serum pentraxin-3 levels in acute stroke: No association with stroke prognosis. Atherosclerosis 2015; 243:616-20. [PMID: 26546709 DOI: 10.1016/j.atherosclerosis.2015.10.089] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 10/10/2015] [Accepted: 10/20/2015] [Indexed: 11/23/2022]
Abstract
BACKGROUND Stroke is the leading cause of serious disability. Estimating severity of the disease and early risk assessment is crucial. Several studies have been carried on and several biomarkers have been proposed in the literature for risk assessment and to estimate the stroke prognosis. In this study we assessed the association of predictors such as patient age, gender, stroke volume and NIHS scores on prognosis of stroke event. We investigated whether the serum pentraxin-3 levels are linked with stroke prognosis. METHODS Forty-four stroke patients without cardiovascular risk factors were included in this study. Initial NIHS scores, stroke volumes, serum pentraxin-3 levels and the data regarding the risk factors were collected in the first and seventh days of event. Association of predictors with final NIHS scores were investigated using multivariate regression model. RESULTS Initial NIHS score, initial and final stroke volumes were independently associated with final NIHS score whereas serum pentraxin-3 levels, whether acquired at the first or seventh day of stroke, were not associated with final NIHS score. CONCLUSIONS In stroke patients without cardiovascular, cardiopulmonary and infectious diseases, serum pentraxin-3 levels are not associated with stroke prognosis.
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