Department of Rehabilitation Medicine, the Second Affiliated Hospital of Anhui Medical University, No. 678 Furong Road, Economic and Technological Development Zone, Hefei, Anhui 230601, China.
Department of Neurology, the Second Affiliated Hospital of Anhui Medical University, No. 678 Furong Road, Economic and Technological Development Zone, Hefei, Anhui 230601, China.
Clin Biochem. 2022 Sep;107:67-72. doi: 10.1016/j.clinbiochem.2022.05.001. Epub 2022 May 10.
Interleukin 17A (IL-17A), vascular endothelial growth factor A (VEGF-A) and tumour necrosis factor alpha (TNF-α) are important cytokines detected mostly within two weeks after stroke in previous clinical studies. Longer clinical studies investigating these cytokines are lacking. We aimed to explore the roles of these cytokines in patients within 35 days after cerebral infarction.
Thirty patients with cerebral infarction and 30 healthy individuals were enrolled. Venous blood was collected from each patient at specific times and from each healthy individual only once. Coma and neurological functional deficits of the patients were evaluated by the Glasgow Coma Scale (GCS) and the National Institutes of Health Stroke Scale (NIHSS), respectively. Three cytokines were measured. The correlations among the three cytokines and between each cytokine and the GCS/NIHSS scores were analysed.
IL-17A and TNF-α began to increase on day 1 after cerebral infarction, peaked on day 4, then decreased, and increased again on day 18. IL-17A returned to normal on day 35, but TNF-α remained higher than normal on day 35. VEGF-A began to increase on day 1, peaked on day 7, and returned to normal on day 35. From days 18 to 35, IL-17A was positively correlated with the GCS scores, and both IL-17A and VEGF-A were negatively correlated with the NIHSS scores.
After cerebral infarction, VEGF-A from the acute phase and IL-17A from the early stage of recovery may be important for nerve protection and repair; TNF-α plays a complex role within 35 days.
白细胞介素 17A（IL-17A）、血管内皮生长因子 A（VEGF-A）和肿瘤坏死因子α（TNF-α）是以前的临床研究中在中风后两周内检测到的重要细胞因子。缺乏对这些细胞因子进行更长时间的临床研究。我们旨在探索这些细胞因子在脑梗死患者 35 天内的作用。
纳入 30 名脑梗死患者和 30 名健康对照者。每位患者在特定时间采集静脉血，每位健康对照者仅采集一次。采用格拉斯哥昏迷量表（GCS）和美国国立卫生研究院卒中量表（NIHSS）评估患者的昏迷和神经功能缺损。测量三种细胞因子。分析三种细胞因子之间以及每种细胞因子与 GCS/NIHSS 评分之间的相关性。
IL-17A 和 TNF-α在脑梗死第 1 天开始升高，第 4 天达到峰值，然后下降，第 18 天再次升高。IL-17A 在第 35 天恢复正常，但 TNF-α在第 35 天仍高于正常。VEGF-A 在第 1 天开始升高，第 7 天达到峰值，第 35 天恢复正常。第 18 天至第 35 天，IL-17A 与 GCS 评分呈正相关，IL-17A 和 VEGF-A 与 NIHSS 评分呈负相关。
脑梗死发生后，急性期的 VEGF-A 和恢复期早期的 IL-17A 可能对神经保护和修复有重要作用；TNF-α在 35 天内发挥复杂作用。
