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Importance of Cerebrospinal Fluid Immunobiochemical Patterns of Local Inflammation During Acute Phase of Ischemic Stroke for the Prognosis of  the Disease Outcome

M. Beridze, R. Shakarishvili
Faculty of Neurology with course of Psychiatry, State Medical Academy

Key words: ischemic stroke, local inflammation, Interleukin-6.

 Objective: To determine the correlation between the CSF levels of proinflammatory cytokines’ Interkleukin-1β (IL-1 β), Tumor-necrosis factor-α (TNF- α) and Interleukin-6 (IL-6) within the subsequent 48 hours post ischemic stroke onset and the severity of its clinical cource, and to assess their role as predictors of 1-month functional outcome of stroke.

Methods: Cytokine CSF levels were determined applying the enzyme-linked immunosorbent assay (ELISA). Severity of stroke was assessed by Glasgow Coma Scale (GCS) and National Institute Health Stroke Scale (NIHSS). Patients were divided into two groups : Gr. 1 (n=23)-with severe stroke (NIHSS>15 GCS<14); Gr. 2  (n=17) - with mild stroke (NIHSS<15 GCS=14-15); Outcomes of the disease were determined using Glasgow Outcome Scale (GOS) and Barthel Index (BI).

Results: The IL-1 β, TNF- α CSF levels within 48 hours post stroke onset were significantly elevated compared to controls (P<0.001), while IL-1 β and TNF- α CSF levels during the same period of time did not differ significantly between the study groups (34.14 ± 4.7 versus 30.4 ± 7.3 P>0.5) and (44±5.4 versus 39.4±9.4 P>0.5), respectively.

Slight negative correlation between the TNF- α baseline concentration (48 h-post stroke) and 1-month functional outcome of the stroke was revealed (RIL-1 β  = - 0.78 P<0.5) and (R TNF- α  = - 0.52 P>0.02). IL-6 CSF levels at baseline were apparently different between the groups (58±4.6 versus 21.8±4.4 P<0.01) and had strong negative correlation with the functional outcome of the disease (R IL-6 = - 0.94 P<0.01).

Conclusions: The high CSF level of IL-6 in acute period of the ischemic stroke strongly correlated with severity of disease and could be considered as a relatively reliable predictor of 1-month stroke outcome. 

 

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