Document Detail


An early and sustained peripheral inflammatory response in acute ischaemic stroke: relationships with infection and atherosclerosis.
MedLine Citation:
PMID:  12799026     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Central nervous system and peripheral inflammation is important in the responses to ischaemic stroke, and may also predispose to its development. We aimed to identify (1) the extent to which a peripheral inflammatory response is activated in patients following acute stroke, and (2) whether there was evidence for preexisting peripheral inflammation. Thirty-six patients with ischaemic stroke within 12 h of onset of symptoms had serial blood samples taken up to 12 months for analysis of markers of inflammation. Thirty-six control subjects, individually matched for age, sex and degree of atherosclerosis, were also studied. Median C-reactive protein (CRP) was elevated, relative to controls (2.08 mg/l), from admission (4.31 mg/l) (p</=0.001) until 3 months (2.90 mg/l) (p</=0.01), the greatest elevation occurring at 5-7 days (17.67 mg/l) (p</=0.001). Elevations were also seen in erythrocyte sedimentation rate (ESR) and white blood cell (WBC) count until 3 months. Median plasma IL-6 was also elevated, relative to controls (9 pg/ml), by 24 h after onset of symptoms (22 pg/ml) (p</=0.01), and remained elevated at 5-7 days (23 pg/ml) (p</=0.01), but not at 3 months. Less marked elevations in these markers were seen in patients without evidence of infection except for IL-6, which was not increased in the absence of infection. These data provide evidence of an early and sustained peripheral inflammatory response to acute ischaemic stroke in patients with or without evidence of infection. The very early increase in concentrations of inflammatory markers after stroke may either be induced by stroke itself, or may indicate a preexisting inflammatory condition in stroke patients which may contribute to the development of stroke.
Authors:
Hedley C A Emsley; Craig J Smith; Carole M Gavin; Rachel F Georgiou; Andy Vail; Elisa M Barberan; John M Hallenbeck; Gregory J del Zoppo; Nancy J Rothwell; Pippa J Tyrrell; Stephen J Hopkins
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of neuroimmunology     Volume:  139     ISSN:  0165-5728     ISO Abbreviation:  J. Neuroimmunol.     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2003-06-11     Completed Date:  2003-08-13     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8109498     Medline TA:  J Neuroimmunol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  93-101     Citation Subset:  IM    
Affiliation:
University of Manchester, Manchester, UK. hemsley@fs1.ho.man.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Arteriosclerosis / blood,  complications*,  immunology*
Blood Sedimentation
Brain Ischemia / blood,  immunology*,  physiopathology
C-Reactive Protein / metabolism
Female
Humans
Inflammation / blood,  complications*,  immunology*
Interleukin-6 / blood
Leukocyte Count
Male
Stroke / blood,  immunology*,  physiopathology
Time Factors
Grant Support
ID/Acronym/Agency:
NS26945/NS/NINDS NIH HHS; NS38710/NS/NINDS NIH HHS
Chemical
Reg. No./Substance:
0/Interleukin-6; 9007-41-4/C-Reactive Protein

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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