Abstract
Inflammation plays a crucial role in stroke pathogenesis. Thus, it is not surprising that cytokines, chemokines, and growth factors have been advocated in stroke diagnostics. Our study is the first to evaluate the salivary cytokine profile in patients with ischemic stroke. Twenty-five patients with subacute ischemic stroke and an age-, sex-, and oral hygiene status-matched control group were enrolled in the study. The number of patients was set a priori based on our previous experiment (α = 0.05, test power = 0.9). Salivary concentrations of tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), and interleukin 10 (IL-10) were assessed using an ELISA method. We showed that salivary TNF-α and IL-6 were significantly higher, whereas IL-10 content was statistically lower in both non-stimulated (NWS) and stimulated (SWS) whole saliva of ischemic stroke patients. However, evaluation of cytokines in NWS rather than in SWS may be of greater diagnostic value. Of particular note is salivary TNF-α, which may indicate cognitive/physical impairment in post-stroke individuals. This parameter distinguishes stroke patients from healthy controls and correlates with cognitive decline and severity of functional impairment. It also differentiates (with high sensitivity and specificity) stroke patients with normal cognition from mild to moderate cognitive impairment. Saliva may be an alternative to blood for assessing cytokines in stroke patients, although further studies on a larger patient population are needed.
Highlights
Inflammation plays a crucial role in stroke pathogenesis
We have demonstrated that assessment of tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), and interleukin 10 (IL-10) levels in both NWS and stimulated (NWS) and stimulated (SWS) significantly differentiates stroke patients from healthy controls
Particular attention should be paid to salivary TNF-α, which may be a non-invasive biomarker of cognitive function/physical status in stroke subjects
Summary
Inflammation plays a crucial role in stroke pathogenesis. it is not surprising that cytokines, chemokines, and growth factors have been advocated in stroke diagnostics. Of particular note is salivary TNF-α, which may indicate cognitive/physical impairment in post-stroke individuals This parameter distinguishes stroke patients from healthy controls and correlates with cognitive decline and severity of functional impairment. In response to ischemic brain injury, acute inflammatory reactions are induced, mediated by various cytokines, chemokines, and growth factors[8]. During the acute phase of ischemic stroke, TNF-α is produced by leukocytes circulating in the peripheral blood and its expression is highest between 8 and 24 h after the onset of cerebral ischemia. Under these conditions, other pro-inflammatory cytokines are activated (e.g., interleukin-6 (IL-6) and interleukin-8 (IL-8)). The secretion of interleukin-10 (IL-10) increases, inhibiting the inflammatory r esponse[12]
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