Department of Neurology, College of Physicians and Surgeons, Columbia University, Neurological Institute, 710 West 168th Street, New York, New York 10032, USA.
Nat Rev Neurol. 2016 Oct;12(10):594-604. doi: 10.1038/nrneurol.2016.125. Epub 2016 Sep 12.
Proinflammatory conditions, including acute and chronic infections, have been associated with an increased risk of stroke. The risk of stroke is increased by both the acute and chronic phases of a wide spectrum of proinflammatory conditions, suggesting that the association is related to activation of the inflammatory response rather than the condition itself. Different inflammatory mechanisms probably influence the risk of different stroke subtypes. This hypothesis is supported by observations that high levels of various immune system markers and acute phase reactants in otherwise healthy individuals have also been associated with ischaemic stroke subtypes. C-reactive protein, IL-6 and lipoprotein-associated phospholipase A2 are some of the inflammatory markers that have been associated with stroke risk and prognosis. Multiple epidemiological studies have demonstrated that these markers are associated with the risk of stroke, but the value of these markers in a clinical setting has not yet been proven. Further research is needed to determine whether immune system modulators can lower the risk of stroke in individuals with elevated concentrations of inflammatory markers. Here, we review the association between infection, systemic inflammation, and ischaemic stroke, and discuss the currently recommended preventive methods to decrease the risk of stroke associated with systemic inflammation.
炎症状态,包括急性和慢性感染,与卒中风险增加相关。炎症状态的广泛谱的急性和慢性阶段均增加卒中风险,提示这种相关性与炎症反应的激活有关,而不是与疾病本身有关。不同的炎症机制可能影响不同卒中亚型的风险。该假说得到以下观察结果的支持:在其他方面健康的个体中,各种免疫系统标志物和急性期反应物的高水平也与缺血性卒中亚型相关。C 反应蛋白、IL-6 和脂蛋白相关磷脂酶 A2 是一些与卒中风险和预后相关的炎症标志物。多项流行病学研究已经证明这些标志物与卒中风险相关,但这些标志物在临床环境中的价值尚未得到证实。需要进一步的研究来确定免疫系统调节剂是否可以降低炎症标志物浓度升高的个体发生卒中的风险。在这里,我们综述了感染、全身炎症与缺血性卒中之间的关系,并讨论了目前推荐的预防方法,以降低与全身炎症相关的卒中风险。