Zafar Atif, Ikram Asad, Jillella Dinesh V, Kempuraj Duraisamy, Khan Mohammad Moshahid, Bushnaq Saif, Adam Harold, Ortega-Gutierrez Santiago, Quadri Syed A, Farooqui Mudassir, Zaheer Asgar, Leira Enrique C
Cerebrovascular Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA.
Neurology, School of Medicine, University of Missouri, Columbia, Mo, Usa.
Cureus. 2017 Oct 11;9(10):e1767. doi: 10.7759/cureus.1767.
Interleukin (IL)-37 is a new member of the IL-1 cytokine family with a defined role as a negative feedback inhibitor of proinflammatory responses. IL-37 has yet to be evaluated in non-immune-mediated neurological diseases, such as ischemic or hemorrhagic strokes. This study aimed to measure urine and serum IL-37 levels in patients with ischemic stroke. Twelve patients consented for our study. Two sets of serum and urine samples were obtained and analyzed, one upon admission to the hospital and the second the next morning. The trends in serum levels of IL- 37 in six stroke patients and the trends in the urine levels of eight stroke patients were measured by real-time polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA). Our pilot study showed IL-37 levels in urine in stroke patients ranging between 210 and 4,534. Serum IL-37 levels were in the range of 44 - 5,235 in patients with ischemic stroke. Three patients who presented within three hours of stroke onset had IL-37 serum levels of 2,655 pg/ml, 3,517 pg/ml, and 5,235 pg/ml, respectively. In all others, it ranged much less than that, with the trend of delayed presentation giving lower IL-37 levels. The study shows a rather stable early elevation of serum IL-37 levels post-ischemic stroke. IL-37 plays a certain role in mediating post-stroke inflammation with a significant increase in serum levels of this novel cytokine observed in ischemic stroke patients. Further large-scale studies need to be done to establish its definite role. A prospective "CRISP" trial is registered with the ClinicalTrials.gov (Identifier: NCT03297827) to determine the role of IL-37 in modulating post-stroke inflammation.
白细胞介素（IL）-37是IL-1细胞因子家族的新成员，作为促炎反应的负反馈抑制剂具有明确作用。IL-37尚未在非免疫介导的神经系统疾病中进行评估，如缺血性或出血性中风。本研究旨在测量缺血性中风患者尿液和血清中的IL-37水平。12名患者同意参与我们的研究。采集并分析了两组血清和尿液样本，一组在入院时采集，另一组在次日早晨采集。通过实时聚合酶链反应（RT-PCR）和酶联免疫吸附测定（ELISA）测量了6名中风患者血清中IL-37水平的变化趋势以及8名中风患者尿液中IL-37水平的变化趋势。我们的初步研究显示，中风患者尿液中的IL-37水平在210至4534之间。缺血性中风患者血清中的IL-37水平在44至5235之间。3名在中风发作后3小时内就诊的患者血清IL-37水平分别为2655 pg/ml、3517 pg/ml和5235 pg/ml。在所有其他患者中，该水平远低于此，且延迟就诊的患者IL-37水平呈下降趋势。该研究表明，缺血性中风后血清IL-37水平早期升高较为稳定。IL-37在介导中风后炎症中发挥一定作用，在缺血性中风患者中观察到这种新型细胞因子的血清水平显著升高。需要进一步开展大规模研究以确定其确切作用。一项前瞻性“CRISP”试验已在ClinicalTrials.gov注册（标识符：NCT03297827），以确定IL-37在调节中风后炎症中的作用。
