低血清肿瘤坏死因子相关凋亡诱导配体（TRAIL）水平与急性缺血性卒中的严重程度相关。

Low serum TNF-related apoptosis-inducing ligand (TRAIL) levels are associated with acute ischemic stroke severity.

作者信息

Kang Yang Ho, Park Min-Gyu, Noh Kyung-Ha, Park Hae Rim, Lee Hye Won, Son Seok Man, Park Kyung-Pil

机构信息

Division of Endocrinology and Metabolism, Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea; Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.

Department of Neurology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea; Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.

出版信息

Atherosclerosis. 2015 May;240(1):228-33. doi: 10.1016/j.atherosclerosis.2015.03.028. Epub 2015 Mar 19.

DOI:10.1016/j.atherosclerosis.2015.03.028

PMID:25813908

Abstract

BACKGROUND

TNF-related apoptosis-inducing ligand (TRAIL) is a member of the tumor necrosis factor receptor superfamily and its serum level is known to be closely associated with future cardiovascular events and prognosis of various cardiovascular diseases. We investigated whether serum TRAIL levels are associated with the severity of acute ischemic stroke and specific stroke subtype.

METHODS

We used an enzyme-linked immunosorbent assay to measure the serum TRAIL levels of 293 patients with acute ischemic stroke within 7 days of onset. Stroke subtype was classified as large artery atherosclerosis, cardioembolism, small vessel occlusion and other determined etiology. We used National Institute of Health Stroke Scale (NIHSS) score of first hospital day and stroke volume on diffusion-weighted imaging within 7 days of stroke onset for measuring the severity of acute ischemic stroke.

RESULTS

The level of serum TRAIL showed significant negative correlations with NIHSS score and stroke volume. Serum TRAIL levels significantly decreased as the tertile of NIHSS score and stroke volume increased. The relative risk of patients with serum TRAIL<64.0 pg/mL for the presence of highest tertile of NIHSS score was significantly increased (adjusted OR [95%CI]; 7.07 [3.64-13.74]). Regarding stroke volume, the relative risk of patients with serum TRAIL<71.5 pg/mL for the presence of highest tertile of stroke volume was also significantly increased (adjusted OR [95%CI]; 2.81 [1.61-4.92]). There are no significant differences of serum TRAIL level among stroke subtypes.

CONCLUSIONS

Low serum TRAIL levels were significantly associated with the acute ischemic stroke severity. This finding suggests that serum TRAIL might also have a role in acute ischemic stroke as well as other cardiovascular diseases.

摘要

背景

肿瘤坏死因子相关凋亡诱导配体（TRAIL）是肿瘤坏死因子受体超家族的成员，已知其血清水平与未来心血管事件及各种心血管疾病的预后密切相关。我们研究了血清TRAIL水平是否与急性缺血性卒中的严重程度及特定卒中亚型相关。

方法

我们采用酶联免疫吸附测定法，测量了293例急性缺血性卒中患者发病7天内的血清TRAIL水平。卒中亚型分为大动脉粥样硬化、心源性栓塞、小血管闭塞及其他明确病因。我们使用首次住院日的美国国立卫生研究院卒中量表（NIHSS）评分及卒中发病7天内弥散加权成像的梗死体积，来评估急性缺血性卒中的严重程度。

结果

血清TRAIL水平与NIHSS评分及梗死体积呈显著负相关。随着NIHSS评分及梗死体积三分位数的增加，血清TRAIL水平显著降低。血清TRAIL<64.0 pg/mL的患者出现最高三分位数NIHSS评分的相对风险显著增加（校正OR [95%CI]；7.07 [3.64 - 13.74]）。关于梗死体积，血清TRAIL<71.5 pg/mL的患者出现最高三分位数梗死体积的相对风险也显著增加（校正OR [95%CI]；2.81 [1.61 - 4.92]）。卒中亚型之间血清TRAIL水平无显著差异。