Ninomiya I, Kanazawa M, Uemura M, Onodera O
Department of Neurology, Brain Research Institute, Niigata University, Niigata, Japan.
Eur J Neurol. 2020 Jul;27(7):1279-1284. doi: 10.1111/ene.14249. Epub 2020 Apr 28.
Branch atheromatous disease (BAD) is one of the stroke subtypes caused by occlusion at the origin of a deep penetrating artery of the brain and is associated with a microatheroma or a junctional plaque. Patients with BAD often develop progressive worsening of neurologic deficits, although these patients often present minor stroke with clinical characteristics of lacunar syndrome at the onset. Pentraxin 3 (PTX3) is known to be a key molecule involved in the pathogenesis of atherosclerosis. Although a high level of serum PTX3 is observed in patients with acute coronary syndrome, there are no reports on PTX3 levels in patients with BAD. This study aimed to investigate whether serum PTX3 levels can distinguish BAD from other stroke subtypes.
We investigated 93 patients with ischaemic stroke. Serum PTX3 levels on admission were measured using enzyme-linked immunosorbent assay in patients with BAD and those with other stroke subtypes (each n ≥ 20).
The median PTX3 levels in patients with BAD (4840 pg/mL) were higher than those with other subtypes of stroke (3397 pg/mL in lacunar stroke, 1298 pg/mL in large-artery atherosclerosis, 1470 pg/mL in cardioaortic embolism and 1006 pg/mL in control) (all P < 0.01).
Our results suggest that elevated serum PTX3 levels might predict the diagnosis of BAD at a very early stage.
分支动脉粥样硬化性疾病(BAD)是由脑深部穿通动脉起始处闭塞引起的中风亚型之一,与微动脉粥样硬化或交界性斑块相关。BAD患者常出现神经功能缺损进行性加重,尽管这些患者发病时多表现为小卒中,具有腔隙综合征的临床特征。已知五聚体3(PTX3)是动脉粥样硬化发病机制中的关键分子。虽然急性冠状动脉综合征患者血清PTX3水平较高,但尚无关于BAD患者PTX3水平的报道。本研究旨在探讨血清PTX3水平是否能将BAD与其他中风亚型区分开来。
我们调查了93例缺血性中风患者。采用酶联免疫吸附测定法测量BAD患者及其他中风亚型患者(每组n≥20)入院时的血清PTX3水平。
BAD患者的PTX3水平中位数(4840 pg/mL)高于其他中风亚型患者(腔隙性中风为3397 pg/mL,大动脉粥样硬化为1298 pg/mL,心源性主动脉栓塞为1470 pg/mL,对照组为1006 pg/mL)(所有P<0.01)。
我们的结果表明,血清PTX3水平升高可能在极早期预测BAD的诊断。