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Selected serum cytokines and vitamin D levels as potential prognostic markers of acute ischemic stroke.
Samarakoon, Nirmali; Chang, Thashi; Gunasekara, Vimukthi; Ratnayake, Praneeth; Jayatillake, Rasika; Udagama, Preethi.
Afiliación
  • Samarakoon N; Faculty of Science, Department of Zoology and Environment Sciences, University of Colombo, Colombo, Sri Lanka.
  • Chang T; Faculty of Medicine, Department of Clinical Medicine, University of Colombo, Colombo, Sri Lanka.
  • Gunasekara V; Faculty of Science, Department of Zoology and Environment Sciences, University of Colombo, Colombo, Sri Lanka.
  • Ratnayake P; Faculty of Science, Department of Zoology and Environment Sciences, University of Colombo, Colombo, Sri Lanka.
  • Jayatillake R; Faculty of Science, Department of Statistics, University of Colombo, Colombo, Sri Lanka.
  • Udagama P; Faculty of Science, Department of Zoology and Environment Sciences, University of Colombo, Colombo, Sri Lanka.
PLoS One ; 19(6): e0299631, 2024.
Article en En | MEDLINE | ID: mdl-38870172
ABSTRACT
Inflammation-derived oxidative stress is postulated to contribute to neuronal damage leading to poor clinical outcomes in Acute Ischemic Stroke (AIS). We aimed to investigate the association between serum levels of selected cytokines (IL-1ß, IFN-γ, IL-4), and vitamin D in ischemic stroke progression, and their accuracy in predicting AIS prognosis, among Sri Lankans. We compared 60 AIS patients admitted in 4 phases post-stroke onset (<6 h; 6-24 h; 24-48 h; 48-96 h; n = 15/phase), with 15 age- and sex-matched controls. The 30-day functional outcome (FO) was assessed using the modified Rankin Scale (mRS). Serum cytokine and vitamin D levels were quantified using sandwich ELISAs, and competitive ELISA, respectively. The CombiROC web tool established optimal prognostic biomarker combinations. Serum IL-1ß and IFN-γ were elevated in all four phases following stroke onset while IL-4 was elevated exclusively in the recovery phase (48-96 h) (p<0.05). Th1 bias polarization of the Th1Th2 cytokine (IFN-γIL-4) ratio occurred with AIS progression while a Th2 bias occurred during AIS recovery (p<0.05). Lower serum IL-1ß and higher IL-4 levels were associated with a good FO (p<0.05), while lower Vitamin D levels were related to a poor FO (p = 0.001). The triple-biomarker panel, IL-4- IFN-γ -Vit D, accurately predicted AIS prognosis (sensitivity = 100%, specificity = 91.9%, area under the curve = 0.98). Serum immunologic mediators IFN-γ, IL-4, and vitamin D may be useful biomarkers of AIS prognosis and may serve as therapeutic targets in improving stroke outcomes. Vitamin D supplementation may improve the prognosis of AIS patients. Furthermore, binary logistic model fitted for FO indicated Th1Th2 cytokine ratio (IFN-γIL-4), vitamin D status, history of stroke, and ischemic heart disease as significant predictors of AIS prognosis.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Vitamina D / Biomarcadores / Citocinas / Accidente Cerebrovascular Isquémico Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2024 Tipo del documento: Article País de afiliación: Sri Lanka Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Vitamina D / Biomarcadores / Citocinas / Accidente Cerebrovascular Isquémico Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2024 Tipo del documento: Article País de afiliación: Sri Lanka Pais de publicación: Estados Unidos