Abstract
BackgroundStudy aimed at investigation of pathogenic role and prognostic value of several selected cerebrospinal fluid acute phase factors that can reflect the severity of ischemic brain damage.MethodsNinety five acute ischemic stroke patients were investigated. Ischemic region visualized at the twenty fourth hour by conventional Magnetic Resonance Imaging. Stroke severity evaluated by National Institute Health Stroke Scale. One month outcome of disease was assessed by Barthel Index. Cerebrospinal fluid was taken at the sixth hour of stroke onset. CSF pro- and anti-inflammatory cytokines were studied by Enzyme Linked Immunosorbent Assay. Nitric Oxide and Lipoperoxide radical were measured by Electron Paramagnetic Resonance. CSF Nitrate levels were detected using the Griess reagent. Statistics performed by SPSS-11.0.ResultsAt the sixth hour of stroke onset, cerebrospinal fluid cytokine levels were elevated in patients against controls. Severe stroke patients had increased interleukin-6 content compared to less severe strokes (P < 0.05). Cerebrospinal fluid Electron Paramagnetic Resonance signal of nitric oxide was increased in patients against controls. Severe stroke group had an elevated Electron Paramagnetic Resonance signal of lipoperoxiradical compared to less severe stroke. Cerebrospinal fluid nitrate levels in less severe stroke patients were higher than those for severe stroke and control. Positive correlation was established between the initial interleukin-6 content and ischemic lesion size as well as with National Institute Health Stroke Scale score on the seventh day. Initial interleukin-6 and nitrate levels in cerebrospinal fluid found to be significant for functional outcome of stroke at one month.ConclusionAccording to present study the cerebrospinal fluid contents of interleukin-6 and nitrates seem to be the most reliable prognostic factors in acute phase of ischemic stroke.
Highlights
Study aimed at investigation of pathogenic role and prognostic value of several selected cerebrospinal fluid acute phase factors that can reflect the severity of ischemic brain damage
At the sixth hour from stroke onset, the cerebrospinal fluid (CSF) proinflammatory cytokine levels in both study groups were elevated compared to the control (P < 0.05)
There was no significant difference in IL-1b and TNF-a contents between the two groups, while Group 1 had significantly increased IL-6 contents compared with Group 2 (P < 0.05)
Summary
Study aimed at investigation of pathogenic role and prognostic value of several selected cerebrospinal fluid acute phase factors that can reflect the severity of ischemic brain damage. Modern concepts of acute cerebral ischemia highlight the role of neurovascular units and emphasize the importance of integrative tissue responses that result from dynamic interactions of endothelial cells, vascular sooth muscles, matrix elements, astroglia, microglia and neurons. By means of inflammatory stimuli and excitoxicity, such interactions create many sources of free toxic radicals and reactive oxygen spices [1]. Endogenous protective mechanisms stabilize the levels of free oxygen radicals closest environment reflecting the immediate immunobiochemical changes in the ischemic brain tissue. The purpose of the present research was to investigate the importance and prognostic value of several selected CSF acute phase factors that are known to reflect the severity of ischemic brain damage
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