Department of Pharmacology and Clinical Pharmacology School of Medical Sciences Faculty of Medical and Health Sciences University of Auckland Auckland New Zealand.
Centre for Brain Research School of Medical Sciences Faculty of Medical and Health Sciences University of Auckland Auckland New Zealand.
Ann Clin Transl Neurol. 2019 Feb 27;6(4):669-677. doi: 10.1002/acn3.743. eCollection 2019 Apr.
Many stroke patients make a partial recovery in function during the first 3 months, partially through promoting insulin-like growth factor-1 (IGF-1) function. A prognostic biomarker that associates with IGF-1 function may predict clinical outcome and recovery of stroke. This study evaluated plasma concentrations of IGF-1, IGF binding protein (IGFBP)-3 and cyclic-glycine-proline (cGP) and their associations with clinical outcome in stroke patients.
Thirty-four patients were recruited within 3 days of stroke. Clinical assessments included the National Institutes of Health Stroke Scale (NIHSS) within 3 days (baseline), and at days 7 and 90; the modified Rankin Scale (mRS) and Fugl-Meyer Upper-Limb Assessment Scale (FM-UL) at days 7 and 90. Plasma samples were collected from the patients at the baseline, days 7 and 90. Fifty age-matched control participants with no history of stroke were also recruited and provided plasma samples. IGF-1, IGFBP-3, and cGP concentrations were analyzed using ELISA or HPLC-MS.
Baseline concentrations of IGFBP-3, cGP, and cGP/IGF-1 ratio were lower in stroke patients than the control group. The neurological scores of stroke patients were improved and plasma cGP and cGP/IGF-1 ratio increased over time. Baseline cGP/IGF-1 ratio was correlated with the NIHSS scores at day 90 and the changes in NIHSS scores from the baseline to 90 days.
Low cGP concentrations and cGP/IGF-1 ratio in stroke patients suggest an impaired IGF-1 function. The cGP/IGF-1 ratio at admission maybe further developed as a prognostic biomarker for stroke recovery.
许多中风患者在发病后的前 3 个月内部分恢复了功能，部分原因是促进了胰岛素样生长因子-1（IGF-1）的功能。与 IGF-1 功能相关的预后生物标志物可能预测中风的临床结果和恢复情况。本研究评估了中风患者发病后 3 天内血浆 IGF-1、IGF 结合蛋白（IGFBP）-3 和环甘氨酸脯氨酸（cGP）的浓度及其与临床结果的关系。
在中风后 3 天内招募了 34 名患者。临床评估包括中风后 3 天内的国立卫生研究院中风量表（NIHSS）（基线），以及第 7 天和第 90 天的改良 Rankin 量表（mRS）和 Fugl-Meyer 上肢评估量表（FM-UL）。在基线、第 7 天和第 90 天收集患者的血浆样本。还招募了 50 名年龄匹配的无中风病史的对照组参与者，并提供了血浆样本。使用 ELISA 或 HPLC-MS 分析 IGF-1、IGFBP-3 和 cGP 浓度。
中风患者的 IGFBP-3、cGP 和 cGP/IGF-1 比值的基线浓度低于对照组。中风患者的神经评分随时间改善，血浆 cGP 和 cGP/IGF-1 比值升高。基线 cGP/IGF-1 比值与第 90 天 NIHSS 评分和从基线到第 90 天 NIHSS 评分的变化相关。
中风患者 cGP 浓度和 cGP/IGF-1 比值较低表明 IGF-1 功能受损。入院时的 cGP/IGF-1 比值可能进一步发展为中风恢复的预后生物标志物。
