Hotter Benjamin, Hoffmann Sarah, Ulm Lena, Meisel Christian, Fiebach Jochen B, Meisel Andreas
Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany.
Center for Stroke Research Berlin, NeuroCure Clinical Research Center and Department of Neurology, Charité University Hospital Berlin, Berlin, Germany.
Front Neurol. 2019 Feb 15;10:83. doi: 10.3389/fneur.2019.00083. eCollection 2019.
We aimed to investigate several blood-based biomarkers related to inflammation, immunity, and stress response in a cohort of patients without stroke-associated infections regarding their predictive abilities for functional outcome and explore whether they correlate with MRI markers, such as infarct size or location. We combined the clinical and radiological data of patients participating in two observational acute stroke cohorts: the PREDICT and 1000Plus studies. The following blood-based biomarkers were measured in these patients: monocytic HLA-DR, IL-6, IL-8, IL-10, LBP, MRproANP, MRproADM, CTproET, Copeptin, and PCT. Multiparametric stroke MRI was performed including T2, DWI, FLAIR, TOF-MRA, and perfusion imaging. Standard descriptive sum statistics were used to describe the sample. Associations were analyzed using Fischer's exact test, independent samples test and Spearmans correlation, where appropriate. Demographics and stroke characteristics were as follows: 94 patients without infections, mean age 68 years (SD 10.5), 32.2% of subjects were female, median NIHSS score at admission 3 (IQR 2-5), median mRS 3 months after stroke 1 (IQR 0-2), mean volume of DWI lesion at admission 5.7 ml (SD 12.8), mean FLAIR final infarct volume 10 ml (SD 14.9), cortical affection in 61% of infarctions. Acute DWI lesion volume on admission MRI was moderately correlated to admission/maximum IL-6 as well as maximum LBP. Extent of perfusion deficit and mismatch were moderately correlated to admission/maximum IL-6 levels. Final lesion volume on FLAIR was moderately correlated to admission IL-6 levels. We found IL-6 to be associated with several parameters from acute stroke MRI (acute DWI lesion, perfusion deficit, final infarct size, and affection of cortex) in a cohort of patients not influenced by infections. www.ClinicalTrials.gov, identifiers NCT01079728 and NCT00715533.
我们旨在研究一组无卒中相关感染患者中几种与炎症、免疫和应激反应相关的血液生物标志物对功能结局的预测能力,并探讨它们是否与MRI标志物(如梗死灶大小或位置)相关。我们整合了参与两项急性卒中观察性队列研究(PREDICT研究和1000Plus研究)患者的临床和放射学数据。对这些患者检测了以下血液生物标志物:单核细胞HLA-DR、IL-6、IL-8、IL-10、LBP、MRproANP、MRproADM、CTproET、 copeptin和PCT。进行了多参数卒中MRI检查,包括T2、DWI、FLAIR、TOF-MRA和灌注成像。使用标准描述性汇总统计数据来描述样本。在适当情况下,采用Fisher精确检验、独立样本检验和Spearman相关性分析进行关联分析。人口统计学和卒中特征如下:94例无感染患者,平均年龄68岁(标准差10.5),32.2%为女性,入院时NIHSS评分中位数为3(四分位间距2-5),卒中后3个月mRS中位数为1(四分位间距0-2),入院时DWI病灶平均体积为5.7 ml(标准差12.8),FLAIR最终梗死灶平均体积为10 ml(标准差14.9),61%的梗死灶累及皮质。入院MRI上的急性DWI病灶体积与入院时/最高IL-6以及最高LBP呈中度相关。灌注缺损程度和不匹配与入院时/最高IL-6水平呈中度相关。FLAIR上的最终病灶体积与入院时IL-6水平呈中度相关。我们发现,在一组未受感染影响的患者中,IL-6与急性卒中MRI的几个参数(急性DWI病灶、灌注缺损、最终梗死灶大小和皮质受累情况)相关。ClinicalTrials.gov,标识符NCT01079728和NCT00715533。