Relationship Between Plasma Resolvin D2/Leukotriene B₄ Ratio And Diabetic Ischemic Stroke

Objective:The ratio of Specialized pro-resolving mediators（SPMs）to leukotriene B4（LTB₄）is an important pro-resolving/pro-inflammatory balance index,which has been found to play as an important indicator in the occurrence and development of inflammatory diseases.However,the significance of resolvin D2（RvD2）/LTB₄ in ischemic stroke complicated with diabetes mellitus is still unclear.The present prospective study analyzed the ratio of plasma RvD2 to LTB₄in stroke patients with diabetic,and explored the relationship between the ratio of RvD2/LTB₄and the severity and prognosis of diabetic ischemic stroke,so as to provide novel theoretical basis for the prevention and treatment of diabetic ischemic stroke.Methods:Patients with acute ischemic stroke were enrolled in the Department of Neurology of Shanghai Sixth People’s Hospital from July 2018 to July 2019.The patients were divided into non-diabetic ischemic stroke group（25 cases）and diabetic ischemic stroke group（32 cases）.Meanwhile,patients diagnosed with type 2 diabetes by the Department of Endocrinology were collected as the diabetes group（33 cases）,and non-diabetic patients with non-neurological problems who were matched in gender and age were also included as the control group（24 cases）.General clinical data and laboratory examination results of all patients were collected.Levels of RvD2 and LTB₄in plasma were determined by ELISA.The m RS score was assessed for 3 months after the onset of stroke.Results:1.Plasma levels of RvD2 were positively correlated to levels of LTB₄;2.the RvD2/LTB₄ ratio in the stroke group was higher than that in non-stroke group（P<0.05）.3.Under non-stroke condition,RvD2/LTB₄ ratio in DM and non-diabetic patients kept the same.But after stroke,diabetic patients had lower plasma RvD2/LTB₄ ratio than non-diabetic patients（P<0.05）.4.There was no significant correlation between RvD2/LTB₄ ratio and infarct size or NIHSS score in stroke patients overall.5.The baseline RvD2/LTB₄ratio in the poor prognosis group was significantly lower than that in the good prognosis group（P<0.05）.6.Plasma levels of LTB₄ and the RvD2/LTB4 ratio were not risk factors for ischemic stroke in diabetic patients（P>0.05）.Conclusion:1.The ratio of RvD2/LTB₄ was significantly increased after cerebral infarction,suggesting the intrinsic protective response against stroke;2.diabetes disturb the balance between the pro-resolving/pro-inflammatory mediator after stroke,as shown by reduced ratio of RvD2/LTB₄ in diabetic patients with cerebral infarction.3.The reduced RvD2/LTB₄ ratio in the acute phase of stroke may predict a poor prognosis.