Correlation Of NLRP3 Inflammasome And Its Downstream Cytokines Interleukin-18 With Acute Ischemic Stroke

ObjectiveTo investigate the clinical relevance of nucleotide-binding leucine-rich repeat proteins 3(NLRP3)inflammasome and its downstream cytokine interleukin-18(IL-18)in peripheral circulation to patients with acute ischemic stroke(AIS).Methods1.A total of 197 patients with AIS who were admitted to the emergency department of People’s Hospital of Zhengzhou University from December 2018 to May 2019 and met the inclusion criteria were included.A total of 100 healthy control patients were included in the physical examination center of People’s Hospital of Zhengzhou University during the same period.2.At admission,basic information of all the subjects,such as gender,age,NIHSS score,smoking history,alcohol consumption history,blood glucose level and total cholesterol level,were collected.3.The Modified Rankin Scale(m RS)was used to score all patients with AIS at discharge.All patients were followed up by telephone one year after discharge,and the MRS score was repeated.According to the results of m RS,the patients were defined as favorable functional outcome(m RS 0-2)and unfavorable functional outcome(m RS 3-6).4.All into the group of patients on admission and practical EDTA tube venous blood was collected 5 ml,separation and extraction of peripheral blood plasma,red blood cell cracking method is used to extract totalRNA,in AIS patients peripheral blood by RT-PCR detection AIS patients and healthy controls in the peripheral blood NLRP3 mRNA expression level,enzyme-linked immunosorbent assay(ELISA)was used to detect the expression level of serum IL-18 in patients with AIS.5.Statistical software SPSS23.0 and Graphpad8.0 were used for statistical analysis.P < 0.05 was defined as statistically significant.Results1.There were no significant differences in gender,age,history of hypertension,history of diabetes,history of smoking,history of alcohol consumption,blood glucose level and total cholesterol level between AIS patients and healthy control group(P >0.05).and the levels of NLRP3 mRNA and serum IL-18 expression in AIS patients were higher than those in healthy control group,and the differences were statistically significant(P<0.05).2.In AIS patients,NLRP3 mRNA and plasma IL-18 expression levels in peripheral blood nucleated cells were positively correlated with NIHSS score reflecting the severity of ischemic stroke(P < 0.05).3.In AIS patients,the expression level of plasma IL-18 in peripheral blood of the patients with unfavorable functional outcome was higher than that of patients with favorable functional outcome at discharge and follow-up after one year of discharge(P< 0.05),and the expression level of plasma IL-18 in peripheral blood of the death group was higher than that of the non-death group within one year of discharge(P < 0.05).4.The median level of plasma IL-18 in AIS patients was 332.66pg/ml.Multivariate logistic regression analysis showed that IL-18 > 332.66pg/ml was an independent risk factor for unfavorable functional outcome at discharge and one year after discharge(P< 0.05).Conclusions1.The levels of NLRP3 mRNA and plasma IL-18 expression in peripheral blood of AIS patients were higher than those of healthy controls.2.NLRP3 mRNA and plasma IL-18 expression levels in peripheral blood of patients with AIS were positively correlated with the severity of the disease.3.Elevated plasma IL-18 level was an independent risk factor for poor prognosis in patients with AIS at discharge and one year after discharge.