Collateral circulation and Toll-like receptor 4 levels in patients with acute cerebral infarction after intravenous thrombolysis

Abstract

To investigate the relationship between Toll-like receptor 4 (TLR4) and collateral circulation in patients with acute cerebral infarction (AIS) after thrombolytic therapy. This retrospective, observational cohort study was conducted among 65 patients with AIS receiving thrombolytic therapy, who were divided according to findings by computed tomographic angiography (CTA) into good collateral circulation (group A, n = 34) and poor collateral circulation (group B, n = 31). Serum samples were collected from all the patients and the levels of TLR4 were measured with ELISA. The patients in group A had significantly better outcomes than those in group B. The NIHSS scores at 24 h and 30 days after thrombolytic therapy, mRS scores at 90 days and serum TLR4 levels were significantly lower in group A than in group B (P < 0.05); the percentages of patients with symptomatic intracerebral hemorrhage were comparable between the two groups. The serum levels of TLR4 were negatively correlated with the rMLC score (P < 0.05). Multivariate logistic regression analysis showed that a high level of TLR4 was associated with a poor collateral circulation after thrombolysis. Good collateral circulation can increase the benefit of intravenous thrombolysis in patients with ACI, and the level of TLR4 is a predictive factor for the compensation of collateral circulation following ACI.