Increase in jugular levels of polymorphonuclear neutrophil elastase in patients with acute cerebral infarction

Abstract

To elucidate the involvement of activated polymorphonuclear neutrophil (PMN) proteolytic activity in the pathophysiology of cerebrovascular stroke, we measured internal jugular venous and femoral arterial levels of PMN elastase in 6 patients with acute stroke from the day of onset (day 0) to 7 days after onset (day 7). Two patients with cerebral infarction demonstrated markedly elevated levels of PMN elastase in the jugular blood (730 and 1320 µg l-1, respectively), but not in the arterial blood (203 and 205 µg l-1, respectively) on day 2. Both patients manifested signs of hemorrhagic infarction early on day 2. On day 4, the increased levels ofjugular PMN elastase returned to the normal range (250 µg l-1, in both patients. In contrast, none of the 4 patients with intracerebral hemorrhage demonstrated increased levels ofPMN elastase in either the jugular or the arterial blood from days 0 to 7. The present study demonstrated a temporary but significant increase in jugular PMN elastase in patients with cerebral infarction, especially shortly after hemorrhagic infarction. [Neural Res 1998; 20: 397–402]