Inflammation biomarkers in acute ischemic stroke according to different etiologies

The Role of IL-6 in Ischemic Stroke

The pathophysiology of a stroke is a complex process involving oxidative stress and inflammation. As a result of the actions of reactive oxygen species (ROS), not only does vascular damage occur, but the brain tissue is also damaged. It is a dynamic process, induced by a cellular-molecular immune response, focused on the development of an immediate reaction. During ischemia, inflammatory mediators are released, among which IL-6 plays a particularly important role in the acute phase of a stroke. Recently, a lot of attention has been devoted to this pleiotropic pro-inflammatory cytokine, which enhances the migration of leukocytes and is controlled by chemokines and the expression of adhesion handlers. The impact of IL-6 on the severity of neurological treatment and on patient prognosis in AIS is of interest to many researchers. More and more data indicate that it may be a reliable prognostic factor in strokes.

Thrombus composition in ischaemic stroke: histological and radiological evaluation, and implications for acute clinical management

Ischaemic stroke is one of the key causes of morbidity and mortality worldwide. Although rapid reperfusion through thrombolysis or mechanical thrombectomy is the cornerstone of acute management, the efficacy of these interventions is influenced by the underlying composition of the occluding thrombus, which varies widely. Histological examination of retrieved thrombi allows the determination of thrombus composition and may inform aetiology and secondary prevention strategies. Additionally, radiological features may provide valuable pre-treatment insights into thrombus composition to help predict treatment success. This narrative review discusses histological and radiological indicators of thrombus composition, and how this may predict success of thrombolysis and thrombectomy. Furthermore, it discusses how these insights can be applied in the diagnostic work-up of embolic stroke of undetermined source (ESUS), and the potential utility of emerging biomarkers relating to thrombus formation, in order to optimise secondary prevention strategies.

Association between serum inflammatory cytokines levels and post-stroke depression among stroke patients: A meta-analysis and systematic review

BACKGROUND

Post-stroke depression (PSD) is a common neuropsychiatric complication after stroke. Neuroinflammation triggered by the stroke event may be its predisposing factor.

METHODS

We systematically searched all electronic databases up to December 22, 2024. Observational studies comparing cytokine levels between PSD and non-PSD patients were included. Sensitivity analysis, subgroup analysis, and meta-regression were conducted to assess robustness, explore heterogeneity, and identify effect modifiers.

RESULTS

A total of 26 studies with 6573 acute stroke patients were included, of whom 2453 developed PSD. PSD patients were older (63.7 vs. 62.8 years) and included more females (36.4 % vs. 35.1 %) than non-PSD patients. PSD patients had significantly higher serum levels of IL-1β (SMD = 0.35, 95 % CI = [0.07, 0.63], p = 0.02), IL-6 (SMD = 0.74, 95 % CI = [0.50, 0.97], p < 0.001), IL-18 (SMD = 0.49, 95% CI = [0.13, 0.86], p = 0.007), TNF-α (SMD = 0.44, 95 % CI = [0.15, 0.72], p = 0.003) and IFN-γ (SMD = 0.11, 95 % CI = [0.02, 0.19], p = 0.01), while IL-10 levels showed no significant difference (p = 0.06). IL-6 levels remained associated with PSD diagnosis at 1, 3 and 6 months. Meta-regression identified female proportion (IL-6: p = 0.043; IL-10: p = 0.024), mean age (IL-18: p = 0.015; TNF-α: p = 0.040), BMI (IL-18: p = 0.019), and diabetes proportion (IL-6: p = 0.009; TNF-α: p = 0.033) as significant moderators.

CONCLUSIONS

Inflammatory cytokines may serve as biomarkers for PSD, offering insights into its pathophysiology and potential diagnostic tools. Prospero registration number: CRD42024548753.

Molecular Links and Clinical Effects of Inflammation and Metabolic Background on Ischemic Stroke: An Update Review

Stroke is a major global health concern, with 12.2 million new cases and 6.6 million deaths reported in 2019, making it the second leading cause of death and third leading cause of disability worldwide. Ischemic stroke, caused by blood vessel occlusion, accounts for 87% of stroke cases and results in neuronal death due to oxygen and nutrient deprivation. The rising global stroke burden is linked to aging populations and increased metabolic risk factors like high blood pressure, obesity, and elevated glucose levels, which promote chronic inflammation. This article explores the intricate molecular and clinical interplay between inflammation and metabolic disorders, emphasizing their role in ischemic stroke development, progression, and outcomes.

Macrophage migration inhibitor factor (MIF): Potential role in cognitive impairment disorders

Macrophage migration inhibitory factor (MIF) is a cytokine in the immune system, participated in both innate and adaptive immune responses. Except from immune cells, MIF is also secreted by a variety of non-immune cells, including hematopoietic cells, endothelial cells (ECs), and neurons. MIF plays a crucial role in various diseases, such as sepsis, rheumatoid arthritis, acute kidney injury, and neurodegenerative diseases. The role of MIF in the neuropathogenesis of cognitive impairment disorders is emphasized, as it recruits multiple inflammatory mediators, leading to activating microglia or astrocyte-derived neuroinflammation. Furthermore, it contributes to the cell death of neurons and ECs with the binding of apoptosis-inducing factor (AIF) through parthanatos-associated apoptosis-inducing factor nuclease (PAAN) / MIF pathway. This review comprehensively delves into the relationship between MIF and the neuropathogenesis of cognitive impairment disorders, providing a series of emerging MIF-targeted pharmaceuticals as potential treatments for cognitive impairment disorders.

Exploring clinical indicator variations in stroke patients with multiple risk factors: focus on hypertension and inflammatory reactions

BACKGROUND

Stroke stands as the second leading cause of death worldwide. Currently, extensive research has been conducted on stroke risk factors. However, when stroke patients contend with multiple risk factors, the impact on clinical indicators remains uncertain.

OBJECTIVES

This study seeks to investigate potential significant variations among distinct ranges of clinical indicators in instances where stroke patients experience multiple risk factors and various ischemic stroke subtypes.

MATERIAL AND METHODS

The research encompassed 440 stroke patients admitted to the First People's Hospital of Wenling City, Zhejiang Province, China. These patients were classified based on the type and quantity of risk factors and subtypes of ischemic stroke they presented. The χ2 test was employed to assess the relationship between the risk of comorbid diseases and clinical indicators in stroke patients.

RESULTS

The results of our study have underscored a significant correlation between various comorbid risk factors in stroke patients and the patients' age (P < 0.010). Furthermore, we observed noteworthy disparities in the plasma levels of IL-2, IL-4, IL-6, IL-10, TNF-α, and INF-γ between patients devoid of risk factors and those presenting with comorbid risk factors associated with stroke. Significant differences in INF-γ were observed between the two subtypes of ischemic stroke, namely lacunar infarction and cardioembolic stroke.

CONCLUSION

Age is correlated with an elevated risk of stroke. Individuals exhibiting multiple stroke risk factors and diverse ischemic stroke subtypes commonly present with abnormal lipid levels and imbalances in Th1/Th2 cytokines. These factors significantly contribute to the onset and progression of stroke. Furthermore, inflammatory responses, particularly those induced by atherosclerosis, play a pivotal role in the genesis of stroke and exert a substantial influence on its prognosis.