[Neutrophil respiratory burst and the state of hemostasis in patients with ischemic and hemorrhagic stroke]

AIM

To study the relationship between the state of the respiratory burst of neutrophils and the indices of hemostasis in patients with ischemic (IS) and hemorrhagic (HS) strokes.

MATERIAL AND METHODS

Thirty-three patients with IS and 31 patients with HS were examined in the first 24 hours after an acute cerebrovascular accident (ACA). The diagnosis of ASA was confirmed by neuroimaging methods: computed tomography and magnetic resonance imaging. The determination of the respiratory burst state of blood neutrophils was carried out using chemiluminescence analysis. Indicators of vascular-platelet and coagulation hemostasis were determined in all patients.

RESULTS AND CONCLUSION

There were changes in the kinetics and activity of neutrophil respiratory burst in stroke patients. Patients with HS had higher (compared to those of patients with IS) level of spontaneous and induced synthesis of secondary ROS but with a decrease in metabolic resources for their synthesis. Activation of spontaneous and ADP-induced platelet aggregation was detected only in HS. Patients with HS had a higher level of fibrinolytic activity as compared to the patients with IS. There were positive correlations between the kinetic parameters of blood coagulation and the synthesis of primary ROS by neutrophils in patients with HS, whereas the intensity of all ROS synthesis negatively correlated with activated partial thromboplastin time. Therefore, in patients with HS the synergistic relationship between the respiratory burst of neutrophils (pro-inflammatory activity) and coagulation hemostasis was more pronounced compared to patients with IS.

[A comparative assessment of indicators of platelet aggregation and interleukins in patients with different outcomes of ischemic stroke]

AIM

To compare indicators of platelet aggregation (PA) and the level of interleukins IL-1β, IL-4, IL-6, IL-18 in patients with ischemic stroke (IS).

MATERIAL AND METHODS

A prospective clinical cohort study involved 108 IS patients classified into group 1 (survivors) and group 2 (fatal outcomes). The studies were conducted in the most acute and acute phases of IS. The level of interleukins was measured by enzyme immunoassay method. PA was evaluated by the nephelometric method.

RESULTS AND CONCLUSION

PA, IL-1β and IL-6 indicators in the most acute phase of IS were significantly higher in the 2^nd group compared to the 1^st group. In the 1^st group, there was a reduction in the levels of IL-1β and IL-6, and an increase in the level of IL-4 in the acute phase compared to the most acute period of IS, whereas patients of the 2^nd group showed further increase in IL-1β and IL-6, and reduction of IL-4 levels. In surviving acute IS patients, the reduction in PA and the level of pro-inflammatory interleukins IL-1b, IL-6 and IL-18, and the increase in the level of anti-inflammatory interleukin IL-4 were accompanied with improvements in the clinical condition, whereas the negative dynamics of the aforementioned indicators was recorded in deceased patients.

[Prognostic significance of indices of platelets aggregation and interleukin-1β in the acute period of ischemic stroke]

AIM

To determine the prognostic significance of indices of platelet aggregation (PA) and the level of interleukin IL-1β in the outcome of ischemic stroke (IS).

MATERIAL AND METHODS

One hundred and eight patients were studied. According to disease outcome, two groups of patients were identified: survivors (group 1) and patients with fatal outcome (group 2). Patients were examined in the very early stage (the 1^st day of hospitalization) and in the early stage (the 7^th day of hospitalization) of IS. The level of interleukin IL-1β in blood serum was defined by enzyme immunoassay method. PA was measured by nephelometric method.

RESULTS AND CONCLUSION

According to PA indices, a posteriori prognosis of fatal outcome was 10%, but according to IL-1β indices, it was 0.90%. Consequently, the prognostic significance of PA indices with regard to fatal outcome of IS patients in the acute period is higher than that of IL-1b indices. Taking into consideration the expenses of both methods of diagnosis, the authors conclude that with regard to economic availability, PA measurement as a prognostic-diagnostic method is more acceptable in clinical practice.

The association of IL-17A polymorphisms with IL-17A serum levels and risk of ischemic stroke

The aim of our study was to investigate the association of interleukin-17A (IL-17A) polymorphisms with IL-17A serum levels and risk of ischemic stroke (IS) in a Chinese population. 392 IS patients and 443 controls were included in this study. The polymorphisms of IL-17A gene were determined by Snapshot SNP genotyping assay and DNA sequencing. Serum IL-17A levels were measured by enzyme-linked immunosorbent assay (ELISA). We found that the G allele, GA and GG genotypes, and GA/GG vs. AA model of rs2275913 polymorphism were associated with increased risk of IS even after adjusted by clinical characters such as age, gender and diabetes (G vs. A: OR=1.27, 95% CI, 1.05∼1.54, P=0.014; GA vs. AA: OR=1.72, 95% CI, 1.05∼2.81, P=0.032; GG vs. AA: OR=1.99, 95% CI, 1.08∼3.67, P=0.028; GA/GG vs. AA: OR=1.78, 95% CI, 1.11∼2.86, P=0.017). Serum IL-17A levels were increased in IS patients compared with controls (P<0.01). Individuals carrying rs2275913 GA or GG genotype present higher serum IL-17A levels compared with the rs2275913AA genotype in the IS group (P<0.01). In conclusion, this is the first study reporting the rs2275913 polymorphism as a risk factor for IS, which may be partly explained by influencing the levels of IL-17A cytokine.