Peak plasma interleukin-6 and other peripheral markers of inflammation in the first week of ischaemic stroke correlate with brain infarct volume, stroke severity and long-term outcome |
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Authors: | Craig J Smith Hedley CA Emsley Carole M Gavin Rachel F Georgiou Andy Vail Elisa M Barberan Gregory J del Zoppo John M Hallenbeck Nancy J Rothwell Stephen J Hopkins Pippa J Tyrrell |
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Affiliation: | 1. University of Manchester, Manchester, M13 9PT, UK 2. Stroke Services, Clinical Sciences Building, Hope Hospital, Salford, M6 8HD, UK 3. Accident and Emergency Medicine, Hope Hospital, Salford, M6 8HD, UK 4. Biostatistics Group, University of Manchester, Hope Hospital, M6 8HD, Salford, UK 5. Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, CA, USA 6. Stroke Branch, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD, USA 7. School of Biological Sciences, University of Manchester, M13 9PT, Manchester, UK 8. North Western Injury Research Collaboration (NWIRC), Clinical Sciences Building, Hope Hospital, M6 8HD, Salford, UK
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Abstract: | Background Cerebral ischaemia initiates an inflammatory response in the brain and periphery. We assessed the relationship between peak values of plasma interleukin-6 (IL-6) in the first week after ischaemic stroke, with measures of stroke severity and outcome. Methods Thirty-seven patients with ischaemic stroke were prospectively recruited. Plasma IL-6, and other markers of peripheral inflammation, were measured at pre-determined timepoints in the first week after stroke onset. Primary analyses were the association between peak plasma IL-6 concentration with both modified Rankin score (mRS) at 3 months and computed tomography (CT) brain infarct volume. Results Peak plasma IL-6 concentration correlated significantly (p < 0.001) with CT brain infarct volume (r = 0.75) and mRS at 3 months (r = 0.72). It correlated similarly with clinical outcome at 12 months or stroke severity. Strong associations were also noted between either peak plasma C-reactive protein (CRP) concentration or white blood cell (WBC) count, and all outcome measures. Conclusions These data provide evidence that the magnitude of the peripheral inflammatory response is related to the severity of acute ischaemic stroke, and clinical outcome. |
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