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Gusev E, Solomatina L, Bochkarev P, Zudova A, Chereshnev V. The Role of Systemic Inflammation in the Pathogenesis of Spontaneous Intracranial Hemorrhage in the Presence or Absence of Effective Cerebral Blood Flow. J Clin Med 2024; 13:4454. [PMID: 39124721 PMCID: PMC11313124 DOI: 10.3390/jcm13154454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Revised: 07/24/2024] [Accepted: 07/26/2024] [Indexed: 08/12/2024] Open
Abstract
Background: Spontaneous intracerebral hemorrhage (ICH) is one of the leading causes of mortality in intensive care units. The role of systemic hyperintense inflammation (SHI) in the pathogenesis of critical complications of ICH remains a poorly understood problem. There is a specific variant of severe ICH associated with increased intracranial pressure and occlusion of intracranial vessels, defined as ineffective cerebral blood flow (IECBF). Methods: To evaluate the role of SHI in the pathogenesis of severe (comatose) ICH in a dynamic comparison of patients with IECBF (n-26) and without IECBF (n-52). The SHI integral score criterion (SI scale) was used, including certain values of plasma concentrations of IL-6, IL-8, IL-10; TNF-α, PCT, cortisol, myoglobin, troponin I, D-dimer, and, additionally, SOFA scale values. Blood levels of ACTH and neuron-specific enolase (NSE) were also assessed. Results: Twenty-eight-day mortality in severe ICH reached 84.6% (without IECBF) and 96.2% (with IECBF). Clear signs of SHI were detected in 61.5%/87.8% (without IECBF) and 0.0%/8.7% (with IECBF) within 1-3/5-8 days from the onset of ICH manifestation. The lower probability of developing SHI in the IECBF group was associated with low blood NSE concentrations. Conclusions: The development of SHI in ICH is pathogenetically related to the permeability of the blood-brain barrier for tissue breakdown products and other neuroinflammatory factors.
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Affiliation(s)
- Evgenii Gusev
- Institute of Immunology and Physiology Ural Branch of The Russian Academy of Sciences, 620078 Yekaterinburg, Russia; (E.G.); (A.Z.); (V.C.)
| | - Liliya Solomatina
- Institute of Immunology and Physiology Ural Branch of The Russian Academy of Sciences, 620078 Yekaterinburg, Russia; (E.G.); (A.Z.); (V.C.)
| | - Peter Bochkarev
- Sverdlovsk Regional Clinical Hospital No. 1 (GAUZ SO “SOKB No. 1”), 620102 Yekaterinburg, Russia;
| | - Alevtina Zudova
- Institute of Immunology and Physiology Ural Branch of The Russian Academy of Sciences, 620078 Yekaterinburg, Russia; (E.G.); (A.Z.); (V.C.)
| | - Valeriy Chereshnev
- Institute of Immunology and Physiology Ural Branch of The Russian Academy of Sciences, 620078 Yekaterinburg, Russia; (E.G.); (A.Z.); (V.C.)
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Bauer A, Boehme C, Mayer-Suess L, Rudzki D, Knoflach M, Kiechl S, Reindl M. Peripheral inflammatory response in people after acute ischaemic stroke and isolated spontaneous cervical artery dissection. Sci Rep 2024; 14:12063. [PMID: 38802464 PMCID: PMC11130263 DOI: 10.1038/s41598-024-62557-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 05/18/2024] [Indexed: 05/29/2024] Open
Abstract
The systemic inflammatory response following acute ischaemic stroke remains incompletely understood. We characterised the circulating inflammatory profile in 173 acute ischaemic stroke patients by measuring 65 cytokines and chemokines in plasma. Participants were grouped based on their inflammatory response, determined by high-sensitivity C-reactive protein levels in the acute phase. We compared stroke patients' profiles with 42 people experiencing spontaneous cervical artery dissection without stroke. Furthermore, variations in cytokine levels among stroke aetiologies were analysed. Follow-up samples were collected in a subgroup of ischaemic stroke patients at three and twelve months. Ischaemic stroke patients had elevated plasma levels of HGF and SDF-1α, and lower IL-4 levels, compared to spontaneous cervical artery dissection patients without stroke. Aetiology-subgroup analysis revealed reduced levels of nine cytokines/chemokines (HGF, SDF-1α, IL-2R, CD30, TNF-RII, IL-16, MIF, APRIL, SCF), and elevated levels of IL-4 and MIP-1β, in spontaneous cervical artery dissection (with or without ischaemic stroke as levels were comparable between both groups) compared to other aetiologies. The majority of cytokine/chemokine levels remained stable across the study period. Our research indicates that stroke due to large artery atherosclerosis, cardioembolism, and small vessel occlusion triggers a stronger inflammatory response than spontaneous cervical artery dissection.
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Affiliation(s)
- Angelika Bauer
- Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
- VASCage Research Centre on Vascular Ageing and Stroke, Innsbruck, Austria
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Christian Boehme
- Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Lukas Mayer-Suess
- Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Dagmar Rudzki
- Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
- VASCage Research Centre on Vascular Ageing and Stroke, Innsbruck, Austria
| | - Michael Knoflach
- Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
- VASCage Research Centre on Vascular Ageing and Stroke, Innsbruck, Austria
| | - Stefan Kiechl
- Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
- VASCage Research Centre on Vascular Ageing and Stroke, Innsbruck, Austria
| | - Markus Reindl
- Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
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Shi Q, Li R, Qu Z, Lang Y, Sheng G, Ning J, Zhang W. Longitudinal change of six common inflammatory cytokines and their relationship to anxiety, depression, and cognitive impairment in acute ischemic stroke patients. Braz J Med Biol Res 2023; 56:e13025. [PMID: 37878890 PMCID: PMC10591487 DOI: 10.1590/1414-431x2023e13025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/10/2023] [Indexed: 10/27/2023] Open
Abstract
Inflammatory cytokines are known to be involved in acute ischemic stroke (AIS), while the relationship of multiple inflammatory cytokines with mental disorders in AIS is less reported. This research intended to explore the longitudinal variation of common inflammatory cytokines and their correlation with anxiety, depression, and cognitive impairment in AIS patients. Six inflammatory cytokines were detected by enzyme-linked immunosorbent assay among 175 AIS patients at admission (baseline) and on the day (D)1, D3, and D7 after admission. Anxiety, depression, and cognition were evaluated using the Hospital Anxiety and Depression Scale and Mini-Mental State Examination at discharge, respectively. Anxiety, depression, and cognitive impairment rates were 32.6, 39.4, and 19.4%, respectively. Tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, IL-8, and IL-17A increased from baseline to D1, then decreased from D1 to D7 (all P<0.001), while IL-10 presented an opposite trend (P<0.001). Interestingly, TNF-α on D1 and D3, IL-6 on D3, IL-8 on D3 and D7, and IL-17A on D1, D3, and D7 correlated with higher anxiety rate (all P<0.05). TNF-α on D1, D3, and D7, IL-8 at baseline, D1, D3, and D7, IL-17A on D1 and D7 correlated with increased depression rate (all P<0.05). In addition, IL-1β on D1 and IL-17 at baseline, D1, D3, and D7 correlated with elevated cognitive-impairment rate (all P<0.05). Inflammatory cytokines were dysregulated after disease onset, and their longitudinal change correlated with psychological issues in AIS patients.
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Affiliation(s)
- Qun Shi
- Department of Endocrinology, Laizhou People's Hospital, Laizhou, China
| | - Ruorui Li
- Department of Respiratory Medicine, Laizhou People's Hospital, Laizhou, China
| | - Zhiling Qu
- Department of Obstetrics, Laizhou People's Hospital, Laizhou, China
| | - Yonghua Lang
- Department of Neurology, Laizhou People's Hospital, Laizhou, China
| | - Guiling Sheng
- Department of Obstetrics, Laizhou People's Hospital, Laizhou, China
| | - Jiajia Ning
- Department of Cardiology, Laizhou People's Hospital, Laizhou, China
| | - Wanli Zhang
- Department of Neurology, Laizhou People's Hospital, Laizhou, China
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Li L, Han Z, Yang Z, Ma Q, Zhao H, Wang R, Fan J, Zhong L, Hu Y, Liu P, Zheng Y, Luo Y. Circulating Inflammatory Biomarkers Level before Thrombolysis for Acute Ischemic Stroke Predicts Symptomatic Intracerebral Hemorrhage. Aging Dis 2023; 14:9-13. [PMID: 36818569 PMCID: PMC9937699 DOI: 10.14336/ad.2022.0608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/08/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- Lingzhi Li
- Institute of Cerebrovascular Disease Research and Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China.
| | - Ziping Han
- Institute of Cerebrovascular Disease Research and Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China.,Beijing Geriatric Medical Research Center and Beijing Key Laboratory of Translational Medicine for Cerebrovascular Diseases, Beijing, China.
| | - Zhenhong Yang
- Institute of Cerebrovascular Disease Research and Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China.
| | - Qingfeng Ma
- Institute of Cerebrovascular Disease Research and Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China.
| | - Haiping Zhao
- Institute of Cerebrovascular Disease Research and Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China.,Beijing Geriatric Medical Research Center and Beijing Key Laboratory of Translational Medicine for Cerebrovascular Diseases, Beijing, China.
| | - Rongliang Wang
- Institute of Cerebrovascular Disease Research and Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China.,Beijing Geriatric Medical Research Center and Beijing Key Laboratory of Translational Medicine for Cerebrovascular Diseases, Beijing, China.
| | - Junfen Fan
- Institute of Cerebrovascular Disease Research and Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China.
| | - Liyuan Zhong
- Institute of Cerebrovascular Disease Research and Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China.
| | - Yue Hu
- Institute of Cerebrovascular Disease Research and Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China.
| | - Ping Liu
- Institute of Cerebrovascular Disease Research and Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China.
| | - Yangmin Zheng
- Institute of Cerebrovascular Disease Research and Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China.,Beijing Geriatric Medical Research Center and Beijing Key Laboratory of Translational Medicine for Cerebrovascular Diseases, Beijing, China.,Correspondence should be addressed to: Dr. Yumin Luo (Emails: ) and Dr. Yangmin Zheng (), Institute of Cerebrovascular Diseases Research and Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Yumin Luo
- Institute of Cerebrovascular Disease Research and Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China.,Beijing Geriatric Medical Research Center and Beijing Key Laboratory of Translational Medicine for Cerebrovascular Diseases, Beijing, China.,Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China,Correspondence should be addressed to: Dr. Yumin Luo (Emails: ) and Dr. Yangmin Zheng (), Institute of Cerebrovascular Diseases Research and Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
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Hazelwood HS, Frank JA, Maglinger B, McLouth CJ, Trout AL, Turchan-Cholewo J, Stowe AM, Pahwa S, Dornbos DL, Fraser JF, Pennypacker KR. Plasma protein alterations during human large vessel stroke: A controlled comparison study. Neurochem Int 2022; 160:105421. [PMID: 36179808 DOI: 10.1016/j.neuint.2022.105421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Stroke is a major cause of death and disability in the United States. Mechanical thrombectomy (MT) 1 and tissue plasminogen activator are the current treatments for ischemic stroke, which have improved clinical outcomes. Despite these treatments, functional and cognitive deficits still occur demonstrating a need for predictive biomarkers for beneficial clinical outcomes which can be used as therapeutic targets for pharmacotherapy. The aim of this study compares the proteomic expression of systemic arterial blood collected at the time of MT to those from a matched cerebrovascular disease (CVD) control cohort. METHODS The Blood and Clot Thrombectomy Registry and Collaboration (BACTRAC) (clinicaltrials.gov NCT03153683) collects and banks arterial blood, both distal and proximal to the thrombus, from ischemic stroke subjects undergoing MT. Arterial blood from patients undergoing a diagnostic angiogram was also collected and banked as CVD controls. Changes in cardiometabolic and inflammatory proteins between stroke and CVD controls were analyzed via Olink Proteomics. RESULTS Proteins including ARTN, TWEAK, HGF, CCL28, FGF-5, CXCL9, TRANCE and GDNF were found to be decreased in stroke subjects when compared to CVD controls. CXCL1, CCL5, OSM, GP1BA, IL6, MMP-1, and CXCL5 were increased in stroke subjects when compared to CVD controls. These proteins were also significantly correlated to stroke outcome metrics such as NIHSS, infarct volume and MoCA scoring. CONCLUSION Overall, acute stroke patients had an increase in inflammatory proteins with a decrease in trophic proteins systemically compared to matched CVD controls. Using our CVD controls, proteins of interest were directly compared to stroke patients with the same cerebrovascular risk factors instead of statistically controlling for comorbidities. The novel methodology of matching an arterial blood CVD control group to a stroke group, as well as controlling for age and comorbid status add to the literature on prognostic stroke biomarkers, which are specific targets for future therapeutics.
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Affiliation(s)
- Hunter S Hazelwood
- University of Kentucky College of Medicine, 800 Rose Street, MN 150, Lexington, KY, 40536, USA
| | - Jacqueline A Frank
- University of Kentucky Department of Neurology, 740 S. Limestone Street, Kentucky Clinic J-455, Lexington, KY, 40536, USA; University of Kentucky Center for Advanced Translational Stroke Science, 741 S. Limestone Street, BBSRB B463, Lexington, KY, 40536, USA
| | - Benton Maglinger
- Department of Neurology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA, 02215, USA
| | - Christopher J McLouth
- University of Kentucky Department of Biostatistics, 725 Rose Street, 205 Multidisciplinary Science Building, Lexington, KY, 40536, USA; University of Kentucky Department of Neurology, 740 S. Limestone Street, Kentucky Clinic J-455, Lexington, KY, 40536, USA
| | - Amanda L Trout
- University of Kentucky Department of Neurosurgery, 780 Rose Street, Lexington, KY, 40536, USA; University of Kentucky Center for Advanced Translational Stroke Science, 741 S. Limestone Street, BBSRB B463, Lexington, KY, 40536, USA
| | - Jadwiga Turchan-Cholewo
- University of Kentucky Department of Neurology, 740 S. Limestone Street, Kentucky Clinic J-455, Lexington, KY, 40536, USA; University of Kentucky Center for Advanced Translational Stroke Science, 741 S. Limestone Street, BBSRB B463, Lexington, KY, 40536, USA
| | - Ann M Stowe
- University of Kentucky Department of Neurology, 740 S. Limestone Street, Kentucky Clinic J-455, Lexington, KY, 40536, USA; University of Kentucky Department of Neuroscience, 741 S. Limestone Street, BBSRB 4th Floor, Lexington, KY, 40536, USA; University of Kentucky Center for Advanced Translational Stroke Science, 741 S. Limestone Street, BBSRB B463, Lexington, KY, 40536, USA
| | - Shivani Pahwa
- University of Kentucky Department of Neurosurgery, 780 Rose Street, Lexington, KY, 40536, USA; University of Kentucky Department of Radiology, 800 Rose Street, Lexington, KY, 40536, USA; University of Kentucky Department of Neurology, 740 S. Limestone Street, Kentucky Clinic J-455, Lexington, KY, 40536, USA
| | - David L Dornbos
- University of Kentucky Department of Neurosurgery, 780 Rose Street, Lexington, KY, 40536, USA; University of Kentucky Department of Radiology, 800 Rose Street, Lexington, KY, 40536, USA
| | - Justin F Fraser
- University of Kentucky Department of Neurology, 740 S. Limestone Street, Kentucky Clinic J-455, Lexington, KY, 40536, USA; University of Kentucky Department of Neurosurgery, 780 Rose Street, Lexington, KY, 40536, USA; University of Kentucky Department of Radiology, 800 Rose Street, Lexington, KY, 40536, USA; University of Kentucky Department of Neuroscience, 741 S. Limestone Street, BBSRB 4th Floor, Lexington, KY, 40536, USA; University of Kentucky Center for Advanced Translational Stroke Science, 741 S. Limestone Street, BBSRB B463, Lexington, KY, 40536, USA
| | - Keith R Pennypacker
- University of Kentucky Department of Neurology, 740 S. Limestone Street, Kentucky Clinic J-455, Lexington, KY, 40536, USA; University of Kentucky Department of Neuroscience, 741 S. Limestone Street, BBSRB 4th Floor, Lexington, KY, 40536, USA; University of Kentucky Center for Advanced Translational Stroke Science, 741 S. Limestone Street, BBSRB B463, Lexington, KY, 40536, USA.
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