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Jia WL, Jiang YY, Jiang Y, Meng X, Li H, Zhao XQ, Wang YL, Wang YJ, Gu HQ, Li ZX. Associations between admission levels of multiple biomarkers and subsequent worse outcomes in acute ischemic stroke patients. J Cereb Blood Flow Metab 2024; 44:742-756. [PMID: 37975323 PMCID: PMC11197142 DOI: 10.1177/0271678x231214831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 09/18/2023] [Accepted: 10/11/2023] [Indexed: 11/19/2023]
Abstract
The modified Rankin Scale change score (ΔmRS) is useful for evaluating acute poststroke functional improvement or deterioration. We investigated the relationship between multiple biomarkers and ΔmRS by analyzing data on 6931 patients with acute ischemic stroke (average age 62.3 ± 11.3 years, 2174 (31.4%) female) enrolled from the Third China National Stroke Registry (CNSR-III) and 15 available biomarkers. Worse outcomes at 3 months were defined as ΔmRS3m-discharge ≥1 (ΔmRS3m-discharge = mRS3m-mRSdischarge). Adjusted odds ratios (aORs) and their 95% confidence intervals (CIs) were calculated from logistic regression models. At 3-months poststroke, 1026 (14.8%) patients experienced worse outcomes. The highest quartiles of white blood cells (WBCs) (aOR [95%CI],1.37 [1.12-1.66]), high-sensitivity C-reactive protein (hs-CRP) (1.37 [1.12-1.67]), interleukin-6 (IL-6) (1.43 [1.16-1.76]), interleukin-1 receptor antagonist (IL-1Ra) (1.46 [1.20-1.78]) and YKL-40 (1.31 [1.06-1.63]) were associated with an increased risk of worse outcomes at 3 months. Results remained stable except for YKL-40 when simultaneously adding multiple biomarkers to the basic traditional-risk-factor model. Similar results were observed at 6 and 12 months after stroke. This study indicated that WBCs, hs-CRP, IL-6, IL-1Ra, and YKL-40 were significantly associated with worse outcomes in acute ischemic stroke patients, and all inflammatory biomarkers except YKL-40 were independent predictors of worse outcomes at 3 months.
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Affiliation(s)
- Wei-Li Jia
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Ying-Yu Jiang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yong Jiang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xia Meng
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Hao Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xing-Quan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
- Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China
- Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, China
| | - Yi-Long Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China
| | - Yong-Jun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
- Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China
- Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, China
| | - Hong-Qiu Gu
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zi-Xiao Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, China
- Chinese Institute for Brain Research, Beijing, China
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Kristinsson S, Fridriksson J. Genetics in aphasia recovery. HANDBOOK OF CLINICAL NEUROLOGY 2022; 185:283-296. [PMID: 35078606 DOI: 10.1016/b978-0-12-823384-9.00015-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Considerable research efforts have been exerted toward understanding the mechanisms underlying recovery in aphasia. However, predictive models of spontaneous and treatment-induced recovery remain imprecise. Some of the hitherto unexplained variability in recovery may be accounted for with genetic data. A few studies have examined the effects of the BDNF val66met polymorphism on aphasia recovery, yielding mixed results. Advances in the study of stroke genetics and genetics of stroke recovery, including identification of several susceptibility genes through candidate-gene or genome-wide association studies, may have implications for the recovery of language function. The current chapter discusses both the direct and indirect evidence for a genetic basis of aphasia recovery, the implications of recent findings within the field, and potential future directions to advance understanding of the genetics-recovery associations.
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Affiliation(s)
- Sigfus Kristinsson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, United States
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, United States.
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Wang WJ, Lyu TJ, Li Z. Research Progress on PATJ and Underlying Mechanisms Associated with Functional Outcomes After Stroke. Neuropsychiatr Dis Treat 2021; 17:2811-2818. [PMID: 34471355 PMCID: PMC8405222 DOI: 10.2147/ndt.s310764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 06/24/2021] [Indexed: 12/05/2022] Open
Abstract
Cell polarity is an intrinsic property of epithelial cells regulated by scaffold proteins. The CRB (crumbs) complex is known to play a predominant role in the dynamic cooperative network of polarity scaffold proteins. PATJ (PALS1-associated tight junction) is the core component in the CRB complex and has been highly conserved throughout evolution. PATJ is crucial to several important events in organisms' survival, including embryonic development, cell polarity, and barrier establishment. A recent study shows that PATJ plays an important role in functional outcomes of stroke. In this article, we elaborate on the biological structure and physiological functions of PATJ and explore the underlying mechanisms of PATJ genetic polymorphism that are associated with poor functional outcomes in ischemic stroke.
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Affiliation(s)
- Wen-Jie Wang
- Vascular Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, People's Republic of China
| | - Tian-Jie Lyu
- China National Clinical Research Center for Neurological Diseases, Beijing, 100070, People's Republic of China.,National Center for Healthcare Quality Management in Neurological Diseases, Beijing, 100070, People's Republic of China
| | - Zixiao Li
- Vascular Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, People's Republic of China.,China National Clinical Research Center for Neurological Diseases, Beijing, 100070, People's Republic of China.,National Center for Healthcare Quality Management in Neurological Diseases, Beijing, 100070, People's Republic of China.,Chinese Institute for Brain Research, Beijing, 100070, People's Republic of China.,Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, 100070, People's Republic of China
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Tissier R, Hocini H, Tchitchek N, Deye N, Legriel S, Pichon N, Daubin C, Hermine O, Carli P, Vivien B, Tréluyer JM, Lefebvre C, Tisserand P, Dubois-Randé JL, Berdeaux A, Ghaleh B, Lelièvre JD, Levy Y, Cariou A. Early blood transcriptomic signature predicts patients' outcome after out-of-hospital cardiac arrest. Resuscitation 2019; 138:222-232. [PMID: 30885824 DOI: 10.1016/j.resuscitation.2019.03.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 02/27/2019] [Accepted: 03/10/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND Early prognostication is a major challenge after out-of-hospital cardiac arrest (OHCA). AIMS We hypothesized that a genome-wide analysis of blood gene expression could offer new prognostic tools and lines of research. METHODS Sixty-nine patients were enrolled from an ancillary study of the clinical trial NCT00999583 that tested the effect of erythropoietin (EPO) after OHCA. Blood samples were collected in comatose survivors of OHCA at hospital admission and 1 and 3 days after resuscitation. Gene expression profiles were analyzed (Illumina HumanHT-12 V4 BeadChip; >34,000 genes). Patients were classified into two categories representing neurological favorable outcome (cerebral performance category [CPC] = 1-2) vs unfavorable outcome (CPC > 2) at Day 60 after OHCA. Differential and functional enrichment analyses were performed to compare transcriptomic profiles between these two categories. RESULTS Among the 69 enrolled patients, 33 and 36 patients were treated or not by EPO, respectively. Among them, 42% had a favorable neurological outcome in both groups. EPO did not affect the transcriptomic response at Day-0 and 1 after OHCA. In contrast, 76 transcripts differed at Day-0 between patients with unfavorable vs favorable neurological outcome. This signature persisted at Day-1 after OHCA. Functional enrichment analysis revealed a down-regulation of adaptive immunity with concomitant up-regulation of innate immunity and inflammation in patients with unfavorable vs favorable neurological outcome. The transcription of many genes of the HLA family was decreased in patients with unfavorable vs favorable neurological outcome. Concomitantly, neutrophil activation and inflammation were observed. Up-stream regulators analysis showed the implication of numerous factors involved in cell cycle and damages. A logistic regression including a set of genes allowed a reliable prediction of the clinical outcomes (specificity = 88%; Hit Rate = 83%). CONCLUSIONS A transcriptomic signature involving a counterbalance between adaptive and innate immune responses is able to predict neurological outcome very early after hospital admission after OHCA. This deserves confirmation in a larger population.
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Affiliation(s)
- Renaud Tissier
- Inserm, U955, F94000, Créteil, France; Université Paris Est, UMR_S955, UPEC, Ecole Nationale Vétérinaire d'Alfort, F-94000, Créteil, France.
| | - Hakim Hocini
- Inserm, U955, F94000, Créteil, France; Vaccine Research Institute, Université Paris Est-Créteil, F-94000, Créteil, France
| | - Nicolas Tchitchek
- Vaccine Research Institute, Université Paris Est-Créteil, F-94000, Créteil, France; CEA - Université Paris Sud 11 - INSERM U1184, Immunology of Viral Infections and Autoimmune Diseases, IDMIT Infrastructure, F-92265 Fontenay-aux-Roses, France
| | - Nicolas Deye
- Medical ICU, Inserm U942, Lariboisiere Hospital, APHP, F-75010, Paris, France
| | - Stéphane Legriel
- Intensive Care Unit, Versailles Hospital, Le Chesnay, F-78150, France
| | - Nicolas Pichon
- Intensive Care Unit, University Hospital Dupuytren, Limoges, F-87042, France
| | - Cédric Daubin
- CHU de Caen, Department of Medical Intensive Care, Caen, F-14000, France
| | - Olivier Hermine
- Department of Hematology and INSERM U1163 CNRS ERL 8654, Imagine Institute and Necker Hospital, Paris, F-75015, France
| | - Pierre Carli
- SAMU de Paris, Service d'Anesthésie-Réanimation, Hôpital Universitaire Necker- Enfants Malades, Université Paris Descartes, F-75015, Paris, France
| | - Benoît Vivien
- SAMU de Paris, Service d'Anesthésie-Réanimation, Hôpital Universitaire Necker- Enfants Malades, Université Paris Descartes, F-75015, Paris, France
| | - Jean-Marc Tréluyer
- Clinical Research Unit, Paris Centre and Paris Descartes University, Paris, France
| | - Cécile Lefebvre
- Inserm, U955, F94000, Créteil, France; Vaccine Research Institute, Université Paris Est-Créteil, F-94000, Créteil, France
| | - Pascaline Tisserand
- Inserm, U955, F94000, Créteil, France; Vaccine Research Institute, Université Paris Est-Créteil, F-94000, Créteil, France
| | - Jean-Luc Dubois-Randé
- Inserm, U955, F94000, Créteil, France; Université Paris Est, UMR_S955, UPEC, Ecole Nationale Vétérinaire d'Alfort, F-94000, Créteil, France
| | - Alain Berdeaux
- Inserm, U955, F94000, Créteil, France; Université Paris Est, UMR_S955, UPEC, Ecole Nationale Vétérinaire d'Alfort, F-94000, Créteil, France
| | - Bijan Ghaleh
- Inserm, U955, F94000, Créteil, France; Université Paris Est, UMR_S955, UPEC, Ecole Nationale Vétérinaire d'Alfort, F-94000, Créteil, France; APHP, Hôpitaux Universitaires Henri Mondor, Plateforme de Ressources Biologiques, F-94000, Créteil, France
| | - Jean-Daniel Lelièvre
- Inserm, U955, F94000, Créteil, France; Vaccine Research Institute, Université Paris Est-Créteil, F-94000, Créteil, France
| | - Yves Levy
- Inserm, U955, F94000, Créteil, France; Vaccine Research Institute, Université Paris Est-Créteil, F-94000, Créteil, France.
| | - Alain Cariou
- Service de Réanimation Médicale, Hôpitaux Universitaires Paris Centre, Hôpital Cochin, Paris, France
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