TY - JOUR
T1 - Tumor necrosis factor alpha serum levels and inflammatory response in acute ischemic stroke patients
AU - Intiso, Do
AU - Zarrelli, M. M.
AU - Lagioia, G.
AU - Di Rienzo, F.
AU - Checchia De Ambrosio, C.
AU - Simone, P.
AU - Tonali, P.
AU - Cioffi, R. P.
PY - 2004/2
Y1 - 2004/2
N2 - Experimental evidence indicates that tumor necrosis factor alpha (TNF-α) is involved in brain damage following ischemic injury. The present study was designed to monitor serum TNF-α levels in acute stroke patients and to correlate TNF-α levels with lesion size, neurological impairment and vascular risk factors. In 41 patients with ischemic stroke, serum TNF-α levels were serially measured by a solid enzyme amplified sensitivity immunoassay (EASIA) in the first 10 days after stroke onset. Serum fibrinogen and C-reactive protein (CRP), white blood cell (WBC) and neutrophil counts were determined on the same days to monitor acute phase response changes. Lesion size was calculated on computed tomograms by a computer-assisted procedure. Neurological impairment was evaluated on the Canadian Neurological Scale. Forty age-matched subjects were used as controls. Compared to baseline, TNF-α levels significantly increased during the study (p=0.0001), peaking on day 7. Peak TNF-α levels did not correlate with neurological impairment or lesion size. Multivariate analysis showed that sex, age, vascular risk factors and infectious complications did not influence TNF-α levels. Fibrinogen, CRP, WBC and neutrophil concentrations increased, indicating an acute phase response occurred after stroke. In conclusion, serum TNF-α levels showed an early and prolonged increase after stroke onset, unrelated to lesion size, neurological impairment, age, sex, vascular risk factors or infectious complications. Serum increase of TNF-α may be explained as part of the acute phase response occurring in stroke patients.
AB - Experimental evidence indicates that tumor necrosis factor alpha (TNF-α) is involved in brain damage following ischemic injury. The present study was designed to monitor serum TNF-α levels in acute stroke patients and to correlate TNF-α levels with lesion size, neurological impairment and vascular risk factors. In 41 patients with ischemic stroke, serum TNF-α levels were serially measured by a solid enzyme amplified sensitivity immunoassay (EASIA) in the first 10 days after stroke onset. Serum fibrinogen and C-reactive protein (CRP), white blood cell (WBC) and neutrophil counts were determined on the same days to monitor acute phase response changes. Lesion size was calculated on computed tomograms by a computer-assisted procedure. Neurological impairment was evaluated on the Canadian Neurological Scale. Forty age-matched subjects were used as controls. Compared to baseline, TNF-α levels significantly increased during the study (p=0.0001), peaking on day 7. Peak TNF-α levels did not correlate with neurological impairment or lesion size. Multivariate analysis showed that sex, age, vascular risk factors and infectious complications did not influence TNF-α levels. Fibrinogen, CRP, WBC and neutrophil concentrations increased, indicating an acute phase response occurred after stroke. In conclusion, serum TNF-α levels showed an early and prolonged increase after stroke onset, unrelated to lesion size, neurological impairment, age, sex, vascular risk factors or infectious complications. Serum increase of TNF-α may be explained as part of the acute phase response occurring in stroke patients.
KW - Computed tomography
KW - Cytokine
KW - Inflammation response
KW - Ischemic stroke
KW - Tumor necrosis factor
UR - http://www.scopus.com/inward/record.url?scp=1342291175&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=1342291175&partnerID=8YFLogxK
U2 - 10.1007/s10072-003-0194-z
DO - 10.1007/s10072-003-0194-z
M3 - Article
C2 - 14767684
AN - SCOPUS:1342291175
VL - 24
SP - 390
EP - 396
JO - Neurological Sciences
JF - Neurological Sciences
SN - 1590-1874
IS - 6
ER -