Document Type : Original Article
- Fariborz Rezaeitalab 1
- Maryam Esmaeili 1
- Amin Saberi 2
- Zohreh Vahidi 3
- Maryam Emadzadeh 4
- Hamid Reza Rahimi 5
- Niloofar Ramezani 1
- Seyed Zakaria Mirshabani-Toloti 6
1 Department of Neurology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
2 School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
3 School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Inflammation and Inflammatory Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
4 School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Clinical Research Unit, Mashhad University of Medical Sciences, Mashhad, Iran
5 Department of Modern Sciences and Technologies, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
6 Student Research Committee, School of Paramedicine, Mashhad University of Medical Sciences, Mashhad, Iran
Background: Inflammatory processes have been proposed in the pathophysiology of ischemic stroke. The present study was designed to evaluate the relationship between tumor necrosis factor-alpha (TNF-α), interleukin 6 (IL-6), IL 1 beta (IL-1β), and high sensitivity C-reactive protein (hsCRP) with the prognosis and functional outcome in patients with less severe ischemic stroke.
Methods: We measured the level of IL-1β, IL-6, hsCRP, and TNF-α on days 1 and 5 after stroke onset by enzyme-linked immunosorbent assay (ELISA). The infarct volume was assessed using Alberta Stroke Program Early CT Score (ASPECTS) and posterior circulation ASPECTS (pcASPECTS) score in brain computed tomography (CT) scan and magnetic resonance imaging (MRI). The severity of stroke was assessed by applying the National Institutes of Health Stroke Scale (NIHSS) and Modified Rankin Scale (MRS) in 24 hours on day 5and after 3 months from stroke onset. Good outcome was defined as the third month MRS ≤ 2. The association of inflammatory markers and the course of stroke symptoms over time was examined.
Results: Forty-four first-ever stroke patients without concurrent inflammatory diseases with a mean age of 65 years were included. The mean NIHSS and MRS in admission time were 6.5 ± 3.5 and 3.07, respectively. The day 1 and the day 5 levels of IL-1β, IL-6, hsCRP, and TNF-α were not significantly different in good and poor outcome groups (all P-values > 0.05). In addition, they were not significantly associated with the ASPECTS, pcASPECTS, and changes of NIHSS and MRS over time.
Conclusion: The levels of hsCRP, IL-1β, IL-6, and
TNF-α are not reliable predictors of functional outcomes in patients with less severe acute ischemic stroke (AIS).
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