IJIMS.2017.121

Type of Article: Original Research

Volume 5; Issue 1: 2018

Page No.: 555-560

DOI: 10.16965/ijims.2017.121

 

TEMPORAL PROFILE OF SERUM LEVELS OF IL-6 IN ACUTE ISCHEMIC STROKE AND ITS RELATIONSHIP WITH STROKE SEVERITY AND OUTCOME IN INDIAN POPULATION

Saroj Choudhary *1, Debashish Chowdhury 2, T.K.Mishra 3, Sarita Agarwal 4.

*1 MD (Biochemistry), Department of Biochemistry, Maulana Azad Medical College, New Delhi, India.

2 MD (Medicine), DM (Neurology), Department of Neurology, G. B. Pant Hospital, New Delhi, India.

3 MD (Biochemistry), Department of Biochemistry, Maulana Azad Medical College, New Delhi, India.

4 MD (Biochemistry), Department of Biochemistry, Maulana Azad Medical College, New Delhi, India.

Corresponding author: Dr. Saroj Choudhary, Assistant professor, Department of Biochemistry, NDMC Medical College and Hindu Rao Hospital, Delhi-110007, India.

E-Mail: dr.sarojchoudhary28aug@gmail.com

ABSTRACT:

Introduction: Acute ischemic stroke is characterized by sudden loss of blood supply to brain leading to cerebral ischemia and neurological damage.  The ischemic event causes neuroinflammation and release of inflammatory cytokines from immune cells of brain tissues. One of such cytokine is the Interleukin-6 which is released from the neuroglia cells of the brain after an acute ischemic attack.

Purpose of the study: To estimate the serum levels of IL-6 serially at various time intervals in acute ischemic stroke patients and comparing them with healthy control;  to evaluate the association of baseline serum IL-6 levels with stroke severity and outcome.

Materials and method: In 33 cases of acute ischemic stroke IL-6 was measured in serum by ELISA on the day of admission, day seventh, one month, and at third month. Severity of stroke was assessed clinically using national institute of health stroke scale (NIHSS) at day one and radiologically by infarct volume on diffusion weighted imaging (DWI) of MRI within initial seven days. The short term outcome was assessed by NIHSS at seventh day and long term outcome by modified rankin scale (MRS) at 1 month and three months. IL-6 levels were also measured in  age and sex matched 60 healthy controls.

Results:  Serum levels of IL-6 were significantly high among cases than healthy controls at all stages. Baseline IL-6 levels in cases showed a significant positive correlation with stroke severity and outcome.

Conclusion: Baseline levels of IL-6 correlates with stroke severity and predicts worse outcome on short term and long term.

Key words: Ischemic stroke, IL-6, NIHSS, MRS, Infarct volume.

REFERENCES

  1. Smith CJ, Emsley HC, Gagin CM, Georgiou RF, Vail A, Barberan EM. Peak plasma interleukin-6 and other peripheral markers of inflammation in the first week of ischaemic stroke correlate with brain infarct volume, stroke severity and longterm outcome. BMC Neurol 2004;15: 2.
  2. Amantea D, Nappi G, Bernardi G, Bagetta G, Corasaniti MT. Post-ischemic brain damage: pathophysiology and role of inflammatory mediators. Febs J 2009; 276:13-26.
  3. Mihara M, Hashizume M, Yoshida H, Suzuki M, Shiina M: IL-6/IL-6 receptor system and its role in physiological and pathological conditions. Clin Sci(Lond) 2012, 122(4):143–159.
  4. Carlstedt F, Lind L, Lindahl B: Proinflammatory cytokines, measured in a mixed population on arrival in the emergency department, are related to mortality and severity of disease. J Intern Med 1997, 242:361–365
  5. Fassbender K, Rossol S, Kammer T, Daffertshofer M, Wirth S, Dollman M, et al. Proinflammatory cytokines in serum of patients with acute cerebral ischemia: kinetics of secretion and relation to the extent of brain damage and outcome of disease. J Neurol Sci 1994;122:135-9.
  6. Vila N, Castillo J, Davalos A, Chamorro A. Proinflammatory cytokines and early neurological worsening in ischemic stroke. Stroke 2001;31:2325–2329.
  7. Bisdas S, Donnerstag F, Ahl B, Bohrer I, Weissenborn K, Becker H. Comparison of perfusion computed tomography with diffusion-weighted magnetic resonance imaging in hyperacute ischemic stroke. J Comput Assist Tomogr. 2004 Nov-Dec;28(6):747-55.
  8. Adams HP Jr, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL et al. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke. 1993;24:35-41.
  9. Maas MB, Furie KL. Molecular biomarkers in stroke diagnosis and prognosis.Biomark Med. 2009 Aug 1;3(4):363-383.
  10. Emsley HC, Smith CJ, Gavin CM, Georgiou RF, Vail A, Barberan EM, et al.Clinical outcome following acute ischaemic stroke relates to both activation and autoregulatory inhibition of cytokine production. BMC Neurol. 2007 Feb 28;7:5.
  11. Cojocaru IM, Cojocaru M, Tănăsescu R, Iliescu I, Dumitrescu L, Silosi I. Expression of IL-6 activity in patients with acute ischemic stroke. Rom J Intern Med. 2009;47(4):393-6.
  12. Perini F, Morra M, Alecci M, Galloni E, Marchi M, Toso V. Temporal profile of serum anti-inflammatory and pro-inflammatory interleukins in acute ischemic stroke patients. Neurol Sci. 2001 Aug;22(4):289-96.
  13. Kim JS, Yoon SS, Kim YH, Ryu JS. Serial measurement of interleukin-6, transforming growth factor-beta, and S-100 protein in patients with acute stroke. Stroke. 1996 Sep;27(9):1553-7.
  14. Rallidis LS, Vikelis M, Panagiotakos DB, Rizos I, Zolindaki MG, Kaliva K et al. Inflammatory markers and in-hospital mortality in acute ischaemic stroke. Atherosclerosis. 2006 Nov;189(1):193-7.
  15. Orion D, Schwammenthal Y, Reshef T, Schwartz R, Tsabari R, Merzeliak O, et al. Interleukin-6 and soluble intercellular adhesion molecule-1 in acute brain ischaemia. Eur J Neurol. 2008;15:323-8.
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