Abstract
Soluble urokinase plasminogen activator receptor (suPAR) is an inflammatory biomarker elevated in cardiovascular diseases. The aim of this 3-year follow-up prospective study was to evaluate suPAR levels in patients with a first ischemic stroke in correlation with CRP, PCT, NT-proCNP and endothelin 1-21 and to investigate the impact of suPAR on the outcome. Fifty-one patients (mean age 73.7+ = 11.9 years, 26 female and 25 male) were included. Samples were collected on the first (suPAR 1), third (suPAR 3) and seventh days after stroke onset (suPAR 7). Plasma samples were analyzed using ELISA. A phone interview was conducted to collect follow-up information after 24 and 36 months (modified Rankin Scale, mRS). A positive correlation between suPAR levels and other inflammatory biomarkers (except endothelin 3) was observed. A positive correlation between suPAR 3 and mRS score at 24 months was observed (p = 0.042). The logistic regression model revealed no significant effect of suPAR on death occurrence in the first 24 months: suPAR 1 (p = 0.8794), suPAR 3 (p = 0.2757), and suPAR 7 (p = 0.3652). The suPAR level is a potential inflammatory marker in ischemic stroke, and there is a correlation with other markers. There is no major impact on mortality. However, the suPAR level is associated with a degree of disability or dependence in daily activities 2 years after a stroke.
Highlights
Over the last few decades, increased evidence has suggested that chronic inflammation plays a major role in the development of atherosclerosis [1,2]
It is a soluble bioactive form of urokinase plasminogen activator receptor, which is a membrane protein located on various types of cells, including monocytes, macrophages, activated T-lymphocytes, endothelial and smooth muscle cells [7–13], all of which are involved in atherosclerosis [14]
A logistic regression model revealed no significant effect of Soluble urokinase plasminogen activator receptor (suPAR) on mortality in the first 24 months (suPAR1 (p = 0.879), suPAR3 (p = 0.275), suPAR7 (p = 0.365)
Summary
Over the last few decades, increased evidence has suggested that chronic inflammation plays a major role in the development of atherosclerosis [1,2]. Soluble urokinase plasminogen activator receptor (suPAR) is an emerging biomarker which is thought to reflect the activation of the immune system [6]. It is a soluble bioactive form of urokinase plasminogen activator receptor (uPAR, CD 87), which is a membrane protein located on various types of cells, including monocytes, macrophages, activated T-lymphocytes, endothelial and smooth muscle cells [7–13], all of which are involved in atherosclerosis [14]. Is the uPA–uPAR system known to be involved in fibrinolysis through the plasminogen activating pathway, but it regulates angiogenesis, cell proliferation, migration, adhesion and recruitment of inflammatory cells [15–17]. Soluble uPAR is cleaved from the cell membranes and released into the circulation due to either acute or chronic inflammation [6,18]
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