Level Changes And Correlation Of Inflammatory Factors In Ischemic Stroke

Background and objectiveAs a major subtype of cerebrovascular diseases,ischemic stroke has high prevalence and disability rate,which has become a severe disease burden to the whole society.Intravenous thrombolysis and intravascular thrombectomy are the most effective treatments of ischemic stroke,while other effective methods are limited.With progress of research on immunology of cerebrovascular disease,the role of inflammation in ischemic stroke becomes clearer.Recruitment of immune cells,angiogenesis and neurogenesis are all involved in the complex process after stroke ictus and have important impact on disease progression.Changes in serum inflammatory factors have provided a perspective for us to understand the immune response after stroke.There is lack of research which focuses on both acute and non-acute stages due to various stage selections of different studies.More evidence is needed because level changes of some inflammatory and angiogenesis factors have not been clear so far.The correlation between the changes of various factors as well as to the severity of the disease needs more exploration.Methods48 patients with ischemic stroke between January 2018 and May 2018 in Peking Union Medical College Hospital were included,and then divided into acute stage group(31 cases within 2 weeks)and non-acute stage group(17 cases over 2 weeks)according to the time after onset.Serum samples were stored at-80? for the analysis of concentration of several inflammatory factors or biomarkers including IL-6,TNF-?,VCAM-1,VEGF,CXCL12,integrin a v ?3,NSE and S100?by sandwich ELISA.Level of each factor was compared between groups.We also analyzed whether there was correlation between these factors and post-ischemic time(PIT)in each group.We also investigated whether there was correlation between the level of each inflammatory factor and clinical manifestation,risk factors and biochemical indicators.ResultsCompared to the control group,the level of CXCL12 is higher in acute stage group and VCAM-1 is higher in non-acute stage group.After controlling the confounding factors,no significant difference was found in the level of other factors between the groups.In acute stage group,level of IL-6 was found to be negatively correlated with PIT,while VCAM-1 was positively correlated with PIT.In non-acute stage group,a positive correlation was also found between NSE level and PIT.In each group,the association between some risk factors or biochemical test indicators and some inflammatory factors was found,but the correlation between NIHSS score and each inflammatory factor level was not.In terms of the correlation between inflammatory factors,IL-6 was found to be positively correlated with VEGF in acute stage and negatively corealated with CXCL12 in non-acute stage.ConclusionsCXCL12,which is associated with post-stroke inflammatory response,angiogenesis and neurogenesis,was found to elevate in the acute stage,while VCAM-1 elevated in the non-acute stage.During the acute period,the level of IL-6 and VCAM-1 were found to be correlated with PIT.For different stages,some risk factors and clinical indicators may have an impact on the level of inflammatory factors,which cannot be considered to be affected by the severity of stroke.