Intra- and extra-hospital improvement in ischemic stroke patients: influence of reperfusion therapy and molecular mechanisms.
Aged
Brain
/ diagnostic imaging
Female
Glutamic Acid
/ metabolism
Hospitals
Humans
Interleukin-6
/ metabolism
Magnetic Resonance Imaging
Male
Middle Aged
Odds Ratio
Reperfusion
/ methods
Retrospective Studies
Stroke
/ pathology
Thrombolytic Therapy
Tissue Plasminogen Activator
/ therapeutic use
Tomography, X-Ray Computed
Treatment Outcome
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
26 02 2020
26 02 2020
Historique:
received:
29
11
2018
accepted:
31
01
2020
entrez:
28
2
2020
pubmed:
28
2
2020
medline:
25
11
2020
Statut:
epublish
Résumé
Neuroprotective treatments in ischemic stroke are focused to reduce the pernicious effect of excitotoxicity, oxidative stress and inflammation. However, those cellular and molecular mechanisms may also have beneficial effects, especially during the late stages of the ischemic stroke. The objective of this study was to investigate the relationship between the clinical improvement of ischemic stroke patients and the time-dependent excitotoxicity and inflammation. We included 4295 ischemic stroke patients in a retrospective study. The main outcomes were intra and extra-hospital improvement. High glutamate and IL-6 levels at 24 hours were associated with a worse intra-hospital improvement (OR:0.993, 95%CI: 0.990-0.996 and OR:0.990, 95%CI: 0.985-0.995). High glutamate and IL-6 levels at 24 hours were associated with better extra-hospital improvement (OR:1.13 95%CI, 1.07-1.12 and OR:1.14, 95%CI, 1.09-1.18). Effective reperfusion after recanalization showed the best clinical outcome. However, the long term recovery is less marked in patients with an effective reperfusion. The variations of glutamate and IL6 levels in the first 24 hours clearly showed a relationship between the molecular components of the ischemic cascade and the clinical outcome of patients. Our findings suggest that the rapid reperfusion after recanalization treatment blocks the molecular response to ischemia that is associated with restorative processes.
Identifiants
pubmed: 32103074
doi: 10.1038/s41598-020-60216-x
pii: 10.1038/s41598-020-60216-x
pmc: PMC7044227
doi:
Substances chimiques
Interleukin-6
0
Glutamic Acid
3KX376GY7L
Tissue Plasminogen Activator
EC 3.4.21.68
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
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