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. 2012 Jul;15(3):181-5.
doi: 10.4103/0972-2327.99707.

Time course of inflammatory cytokines in acute ischemic stroke patients and their relation to inter-alfa trypsin inhibitor heavy chain 4 and outcome

Amit R Nayak  1 , Rajpal S Kashyap, Dinesh Kabra, Hemant J Purohit, Girdhar M Taori, Hatim F Daginawala
Affiliations

Time course of inflammatory cytokines in acute ischemic stroke patients and their relation to inter-alfa trypsin inhibitor heavy chain 4 and outcome

Amit R Nayak et al. Ann Indian Acad Neurol. 2012 Jul.

Abstract

Background: Biomarker for prognosis of stroke is urgently needed for the management of acute ischemic stroke (AIS) patients.

Objective: To evaluate the course of inflammatory cytokines in AIS patients and its comparison with inter-alfa trypsin inhibitor heavy chain 4 (ITIH4) and outcome after AIS.

Materials and methods: A panel of 12 inflammatory cytokines and ITIH4 were estimated in serial blood samples collected at admission, 24 h, 48 h, 72 h, 144 h and at discharge of AIS patients (n = 5).

Results: Out of the 12 cytokines, only interleukin (IL)-2, tumor necrosis factor-alfa (TNF-α), IL-10, IL-6, IL-1B and IL-8 were in the measurable range of the kit (10 pg/mL). We found high IL-2 at admission, which decreased (P < 0.05) in the follow-up samples. TNF-α initially increases (P < 0.05) at 24 h followed by gradual decrease (P < 0.05) after 72 h. IL-10 decreases initially (P < 0.05) till 72 h as compared with its level at admission and then increases (P < 0.05) after 144 h. Similarly, ITIH4 was down-regulated in the early 72 h followed by further increase with improvement of the patient. ITIH4 correlates with IL-10 and computed tomography scan infarct volume. Serum IL-6, IL-1B and IL-8 increased in the AIS patients, but did not show any pattern.

Conclusions: Serial measurement of IL-10, IL-2 and TNF-α and ITIH4 may be useful for the follow-up of clinical outcome after AIS.

Keywords: Acute ischemic stroke; cytokine; inter-alfa trypsin inhibitor heavy chain 4; prognosis.

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Conflict of interest statement

Conflict of Interest: Nil

Figures

Figure 1
Figure 1
(a) Correlation (with 95% regression confidence limits) between computed tomography scan infarct volume and inter-alfa trypsin inhibitor heavy chain 4 (ITIH4) at admission in acute ischemic stroke (AIS) patients. (b) Correlation (with 95% regression confidence limits) between ITIH4 and interleukin-10 cytokine at admission in AIS patients. (c) ITIH4 levels in the follow-up sample of AIS patients
Figure 3
Figure 3
Correlation (with 95% regression confidence limits) between computed tomography scan infarct volume and inflammatory cytokine at admission in acute ischemic stroke patients
Figure 4
Figure 4
Correlation (with 95% regression confidence limits) between inter-alfa trypsin inhibitor heavy chain 4 and inflammatory cytokine in acute ischemic stroke patients
Figure 2
Figure 2
Temporal profile of serum levels of inflammatory cytokines: (a) tumor necrosis factor-α, (b) interleukin (IL)-1B, (c) IL-2, (d) IL-8, (e) IL-6 and (f) IL-10 in acute ischemic stroke patients at different time intervals. *P < 0.05 vs. admission; #P < 0.05 vs. 24 h
See this image and copyright information in PMC

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