PP.27.15

Abstract

Objective: Proinflammatory immune activation plays substantial role in the pathogenesis of stroke and hypertension progression. Recent studies had been shown that autoimmune biomarkers have been closely related to incidence of cerebral ischemia. Prognostic significance of neuroimmune circulating factors in high-risk hypertensive patients remains to be unclear. T:o evaluate the serum levels of MMP-9 and quantity of NR2-antibodies in post-stroke hypertensive patients compared with never-had-stroke hypertensives and normotensive subjects as well as reveal the prognostic significance of these neuroimmune markers. Design and method: Eighty hypertensive patients (57 men, 23 women) aged 58 ± 3 years were prospectively enrolled for this study. Sixty patients had previous stroke history, twenty patients did not suffer from stroke before enrollment period. Fifteen normotensive subjects without previous cardiovascular events (10 men, 5 women) aged 50 ± 5 years were included in control group. All patients and volunteers gave written, informed consent. Quantitative determination of antibodies to the NR2 NMDA receptor unit in serum was performed using kits of Gold Dot NR2 Antibody Test, (Biotech, INC). MMP-9 serum levels had been determined using R&D Systems kits. Results: The highest levels of MMP-9 and NR2-antibodies were revealed in post-stroke hypertensive patients than the respective value in never-had-stroke patients and in normotensive subjects. Close correlation between MMP-9 and quantity of NR2-antibodies had been established (r = 0,36; p < 0,05). During 18-month follow-up period in eleven patients the incidence of recurrent stroke had been registered. Hazard ratio of stroke recurrence was 1,25 (95% CI 1,06–1,46) in post-stroke hypertensives with level of NR2-antibodies over 3,97 ng/ml compared with those who had lower concentration of this autoimmune parameter. Conclusions: High levels of NR2-antibodies have been considered to be a sensitive and specific prognostic marker of cerebrovascular complication in post-stroke hypertensive patients. Increased level of MMP-9 could reflected the blood-brain barrier's damaging on early stages.