Prediction of the outcome of the acute phase of ischemic stroke: the role of apoptotic markers

Abstract

Introduction. Neuronal cell death (apoptosis) is not only a direct consequence of cerebral infarction, but also a crucial pathogenetic link of ischemic injury. Nevertheless, the role of apoptotic markers in prediction of the functional outcome of the acute phase of ischemic stroke (IS) has not been established. Objective. To determine the possibility of predicting the outcome of the acute phase of ischemic stroke in the earliest period after its development by measuring thes FasL and sFas concentrations in peripheral blood. Materials and methods. One hundred fifty-five individuals underwent in-hospital examination. They were subdivided into 3 groups: the control group included healthy volunteers (n=28) and two groups of patients depending on the outcome of the acute phase of IS: either with favourable (National Institutes of Health Stroke Scale score on day 21 ≤ 5) or unfavourable (the NIHSS score on day 21 > 5) outcomes. Concentrations of sFas and sFasL were measured on day 1, 7, and 21 after ischemic stroke by ELISA; the sFasL/sFas ratio was also determined. Results. The outcome is favourable (NIHSS score on day 21 ≤ 5) if the sFasL/sFas ratio is ≤ 2.11 ± 0.58; otherwise, the outcome is unfavourable (NIHSS scoreon day 21 > 5).Conclusions. The proposed method is characterized by prognostic significance and high accuracy and can be used in clinical practice to determine the strategy for managing patients with IS.