Department II of Emergency, Handan Central Hospital, Handan, 056008, China.
Department I of Neonatal Ward, Handan Central Hospital, Handan, 056008, China.
Ann Clin Transl Neurol. 2024 Apr;11(4):856-865. doi: 10.1002/acn3.51992. Epub 2024 Mar 26.
Autophagy-related 5 (ATG5) facilitates the pathologic process of acute ischemic stroke (AIS) via multiple ways. This study aimed to identify the association of serum ATG5 with clinical outcomes in AIS patients.
Serum ATG5 from 280 AIS patients were detected at admission, Day (D)1, D3, D7, D30, and D90 after admission by enzyme-linked immunosorbent assay. The median (interquartile range) follow-up was 21.1 (5.9-43.9) months. Another 50 healthy controls (HCs) were also enrolled for serum ATG5 determination.
ATG5 was elevated (p < 0.001) (vs. HCs), and positively correlated with hyperlipidemia (p = 0.016), and the national institutes of health stroke scale score (p = 0.001) in AIS patients. Interestingly, ATG5 was increased from admission to D1, but gradually decreased until D90 (p < 0.001). Besides, 85 (30.4%) and 195 (69.6%) AIS patients were assessed as modified Rankin Scale (mRS) >2 and mRS ≤2 at D90, respectively. ATG5 at admission, D1, D3, D30, and D90 was elevated in AIS patients with mRS >2 versus those with mRS ≤2 (all p < 0.050). ATG5 at admission, D1, D3, D7, D30, or D90 was elevated in relapsed (vs. non-relapsed) or died (vs. survived) AIS patients (all p < 0.050). Recurrence-free survival was shortened in AIS patients with high (≥52.0 ng/mL) ATG5 versus those with low (<52.0 ng/mL) ATG5 at admission, D3, D7, and D30 (all p < 0.050); overall survival was shorter in AIS patients with high (vs. low) ATG5 at D7 and D30 (both p < 0.050).
Serum ATG5 elevates at first, thereafter gradually declines, whose elevation associates with neurological dysfunction, recurrence, and death risk in AIS patients.
自噬相关蛋白 5（ATG5）通过多种途径促进急性缺血性脑卒中（AIS）的病理过程。本研究旨在探讨血清 ATG5 与 AIS 患者临床结局的相关性。
采用酶联免疫吸附试验检测 280 例 AIS 患者入院时、入院后第 1 天（D1）、第 3 天（D3）、第 7 天（D7）、第 30 天（D30）和第 90 天（D90）的血清 ATG5 水平。中位（四分位间距）随访时间为 21.1（5.9~43.9）个月。同时纳入 50 例健康对照者（HCs）检测血清 ATG5。
AIS 患者血清 ATG5 水平升高（p<0.001）（与 HCs 比较），且与高脂血症（p=0.016）和美国国立卫生研究院卒中量表评分（p=0.001）呈正相关。有趣的是，AIS 患者入院时血清 ATG5 水平升高，于 D1 达到高峰，此后逐渐下降直至 D90（p<0.001）。此外，90 天时 85 例（30.4%）和 195 例（69.6%）AIS 患者改良 Rankin 量表（mRS）评分>2 和 mRS≤2。与 mRS≤2 患者相比，mRS>2 患者入院时、D1、D3、D30 和 D90 时 ATG5 水平均升高（均 p<0.050）。与存活患者相比，复发（p<0.050）或死亡（p<0.050）患者入院时、D1、D3、D7、D30 时 ATG5 水平升高。AIS 患者入院时、D1、D3、D7、D30 时 ATG5 水平升高者的无复发生存期短于 ATG5 水平较低者（均 p<0.050）；入院时、D7 和 D30 时 ATG5 水平较高者的总生存期短于 ATG5 水平较低者（均 p<0.050）。
血清 ATG5 水平最初升高，随后逐渐下降，其升高与 AIS 患者的神经功能障碍、复发和死亡风险相关。
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