Prognostic value of assessment of glial cell line-derived neurotrophic factor in ischemic stroke patients

Abstract

Objective. The aim of the study was to estimate the prognostic value of GDNF in acute IS patients. Glial neurotrophic factor (GDNF) is a neuropeptide, which promotes the proliferation and differentiation of the cells of the central and peripheral nervous system, possesses antihypoxic and neuroprotective properties in ischemic stroke (IS).
 Materials and methods. 50 patients with first-ever acute IS were examined at the National Institutes of Health Stroke Scale (NIHSS); modified Rankin scale was used on admission to the hospital, 7 and 14 days after stroke. The plasma GDNF level was measured at the first 48 hours and after 7 days of IS onset. GDNF was analyzed by commercially available ELISA kit. The comparison group included 20 healthy persons.
 Results. The average GDNF level in the group of patients with IS (3.4 [2.8; 5.0] pg/ml) was significantly higher than in the group of healthy individuals (2.8 [2.6; 2.9] pg/ml), p = 0.02.
 The risk of unfavourable functional outcome on the day 14 after IS onset was higher by 2.8-fold in those patients whose level of GDNF was increased on the 7th day of the disease by more than 30% compared to its level in the first 48 hours (RR = 2,8; 95% CI [1,45,7]).
 The GDNF level less than 2.9 pg/ml was associated with a high risk of death during 14 days after the IS onset (RR = 6,7; 95% CI [1,530,5]).
 Conclusions. Plasma concentrations of GDNF have a high predictive value for unfavorable functional outcome and risk of death in acute period of IS.