Department of Neurology, Second Hospital of Jilin University, Changchun, China.
Department of Otolaryngology, Second Hospital of Jilin University, Changchun, China.
Oxid Med Cell Longev. 2021 Apr 13;2021:5546991. doi: 10.1155/2021/5546991. eCollection 2021.
This study seeks to assess interleukin-37 (IL-37) serum level in acute ischemic stroke and the value of predicting 3-month stroke recurrence and functional outcome in acute ischemic stroke.
From January 1, 2018, to June 30, 2019, all consecutive first-ever acute ischemic stroke patients from our hospital, China, were included. Serum samples, clinical information, and stroke severity (defined by the National Institute of Health stroke scale (NIHSS) score) were collected at baseline. Serum IL-37 level was measured by the enzyme-linked immunosorbent assay (ELISA) method. Functional impairment (defined by the modified Rankin scale (mRS)) and recurrent stroke were assessed 3 months after admission. The relation of IL-37 with either clinical severity at baseline, unfavorable functional outcome, or stroke recurrence at follow-up was evaluated by logistic regression analysis, and the results were presented as odds ratios (OR) with 95% confidence intervals (CI).
Three hundred and ten stroke patients were included. The median IL-37 serum level in those patients was 344.1 pg/ml (interquartile range (IQR), 284.4-405.3 vs. control cases: 122.3 pg/ml (IQR, 104.4-1444.0); < 0.001). At 3 months, a total of 36 (11.6%) patients had a stroke recurrence. IL-37 serum levels in those patients were higher than in those patients without stroke recurrence (417.0 pg/ml (IQR, 359.3-436.1) vs. 333.3 pg/ml (279.0-391.0)). In a logistic model adjusted for other factors, IL-37 in the highest quartile (>405.3 pg/ml) was still associated with recurrent stroke (OR = 3.32; 95%CI = 2.03-6.13; < 0.001). IL-37 could promote the NIHSS score (area under the curve (AUC) of the IL-37/NIHSS, 0.75; 95% CI, 0.67-0.83; < 0.001), corresponding to a difference of 0.085 (0.005). Serum IL-37 increases in patients with poor outcome, and an IL-37 in the highest quartile is related to poor outcome (OR = 4.85; 95%CI = 3.11 - 8.22; < 0.001).
Serum IL-37 increased in patients after ischemic stroke and was associated with stroke recurrence events and poor stroke outcomes. Large randomized controlled trials should be carried out to confirm whether IL-37 lowering treatment improves stroke prognosis.
本研究旨在评估白细胞介素 37（IL-37）在急性缺血性脑卒中患者中的血清水平，及其对急性缺血性脑卒中患者 3 个月内卒中复发和功能结局的预测价值。
本研究纳入了 2018 年 1 月 1 日至 2019 年 6 月 30 日期间来自中国我院的所有首次急性缺血性脑卒中患者。在基线时收集血清样本、临床信息和卒中严重程度（用国立卫生研究院卒中量表（NIHSS）评分定义）。用酶联免疫吸附试验（ELISA）法测量血清 IL-37 水平。入院后 3 个月评估功能障碍（用改良 Rankin 量表（mRS）定义）和卒中复发情况。通过逻辑回归分析评估 IL-37 与基线临床严重程度、不良功能结局或随访时卒中复发的关系，结果以优势比（OR）及其 95%置信区间（CI）表示。
本研究共纳入了 310 例卒中患者。这些患者的中位血清 IL-37 水平为 344.1 pg/ml（四分位距（IQR），284.4-405.3 与对照组：122.3 pg/ml（IQR，104.4-1444.0）；<0.001）。在 3 个月时，共有 36 例（11.6%）患者发生卒中复发。这些患者的血清 IL-37 水平高于未发生卒中复发的患者（417.0 pg/ml（IQR，359.3-436.1）比 333.3 pg/ml（279.0-391.0））。在调整其他因素的逻辑模型中，四分位距最高的 IL-37（>405.3 pg/ml）仍与卒中复发相关（OR=3.32；95%CI=2.03-6.13；<0.001）。IL-37 可升高 NIHSS 评分（IL-37/NIHSS 的曲线下面积（AUC）为 0.75；95%CI，0.67-0.83；<0.001），对应差值为 0.085（0.005）。血清 IL-37 在预后不良的患者中升高，四分位距最高的 IL-37 与预后不良相关（OR=4.85；95%CI=3.11-8.22；<0.001）。
缺血性脑卒中后患者的血清 IL-37 水平升高，并与卒中复发事件和不良卒中结局相关。应开展大规模随机对照试验以证实降低 IL-37 治疗是否能改善卒中预后。
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