Diagnostic markers of early phase of acute disorder of brain blood circulation in persons with КT-negative infarct data


DOI: https://dx.doi.org/10.18565/therapy.2020.3.27-32

Solovieva E.Yu., Amelina I.P., Baranova O.A., Chekanov A.V.

N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Moscow
The aim: to study of markers of vascular inflammation in patients in the acute phase of ischemic cerebral circulation disorders for early diagnosis and prognosis of the disease.
Material and methods. The study included 108 patients: 39 patients with the new onset of ischemic stroke (IS), 39 – with a transient ischemic attack (TIA) in the acute phase, 30 patients – composed the control group. All patients underwent quantification of D-dimer, lipocalin 2 (NGAL), IL-1, TNF-α by the IFA method and spectrophotometric methods using reagents from «RENAM» (plasminogen, antiplasmin, protein C).
Results. D-dimer was significantly higher in patients with IS than with the TIA (p <0,05). A significant increase in D-dimer was observed at IS compared with the control (p <0,05), which indicates impaired endothelial function and inflammation. However, there was no significant difference in the levels of D-dimer between the TIA group and the control (p >0,05). NGAL was significantly higher in patients with IS compared with the TIA group (p <0,05). In both groups, NGAL was higher than its reference values, which indicates the activation of neutrophils, the progression of oxidative stress and inflammation. The data of IL-1, TNF-α, plasminogen, antiplasmin and protein C markers are comparable to the data of the control group (p >0,05), which, apparently, indicates a delay in marking the inflammation process, and not about the absence of the vascular inflammatory reaction itself.
Conclusion. The levels of D-dimer and NGAL are significantly higher in patients with IS compared to the TIA, which regards these indicators to the diagnostic markers of the early phase of acute cerebrovascular accident in terms of differential diagnosis between CT-negative patients with IS and TIA.
Keywords: endothelial dysfunction, inflammation, ischemic stroke
Read entire article

Literature


  1. Живолупов С.А., Самарцев И.Н., Бутакова Ю.С. Современные критерии рациональной диагностики и лечения цереброваскулярных заболеваний. Невроньюс. 2017; 36(10): 8–9. [Zhivolupov S.A., Samartsev I.N., Butakova Yu.S. Modern criteria of rational diagnosis and treatment of cerebrovascular diseases. Neuronews. 2017; 36(10): 8–9 (In Russ.)].

  2. Муравьева В.Н., Карпова Е.Н. Современные представления о факторах риска и профилактики ОНМК (обзор литературы). Международный журнал экспериментального образования. 2014; 3–2: 59–64. [Muraveva V.N., Karpovа E.N. Modern concepts of risk factors and prevention of stroke (literature review). Mezhdunarodny zhurnal eksperimental'nogo obrazovaniya. 2014; 3–2: 59–64 (In Russ.)].

  3. Ермолаева Т.И., Фомина Р.В. Инсульты у лиц молодого возраста. Здравоохранение Чувашии. 2017; 4: 5–8. [Ermolaeva T.I., Fomina R.V. Strokes in young patients. Zdravookhranenie Chuvashii. 2017; 4: 5–8 (In Russ.)].

  4. Нетесова Е.С., Нетесов Е.В. Нейрональные биомаркеры у пациентов с острой симптоматикой инсульта. Медицина и образование в Сибири. 2016; 2: 4. [Netesova E.S., Netesov E.V. Neuronal biomarkers at patients with acute symptomatology of a stroke. Meditsina I obrazovanie v Sibiri. 2016; 2: 4 (In Russ.)].

  5. Saengen A.K., Christenson R.N. Stroke biomarkers: progress and challenges for diagnosis, prognosis, differentiation and treatment. Clin Chem. 2010; 56(1): 21–33. doi: https://doi.org/10.1373/clinchem.2009.133801.

  6. Sotgiu S., Zanda B., Marchetti B. et al. Inflammatory biomarkers in blood of patients with acute brain ischemia. Eur J Neurol. 2006; 13(5): 505–13. doi: https://doi.org/10.1111/j.1468-1331.2006.01280.x.

  7. Qin C., Fan W.H., Liu Q. et al. Fingolimod protects against ischemic white matter damage by modulating microglia toward M2 polarization via STAT3 pathway. Stroke. 2017; 48(12): 3336–46. doi: https://doi.org/10.1161/strokeaha.117.018505

  8. Chamorro A., Meisel A., Planas A.M. et al. The immunology of acute stroke. Nat Rev Neurol. 2012; 8: 401–10. doi: https://doi.org/10.1038/nrneurol.2012.98.

  9. Franklin T., Krueger-Naug A., Clarke D. The role of heat shock proteins Hsp70 and Hsp27 in cellular protection of the central nervous system. Int. J. of Hyperthermia. 2005; 30(5): 379–92.

  10. Баркаган З.С., Костюченко Г.И., Котовщикова Е.Ф. Гипергомоцистеинемия как самостоятельный фактор риска поражения и тромбирования кровеносных сосудов. Патология кровообращения и кардиохирургия. 2002; 1: 65–71. [Barkagan Z.S., Kostyuchenko G.I., Kotovschikova E.F, Hyperhomocysteinemia as independent risk factor of blood vessel damage and thrombosis. Patologiya krovoobrascheniya i kardiokhirurgiya (In Russ.)].

  11. Heiss W.D. The ischemic penumbra: how does tissue injury evolve? Ann N Y Acad Sci. 2012; 1268: 26–34. doi: 10.1111/j.1749-6632.2012.06668.x.

  12. Chen G.Y., Nunez G. Sterile inflammation: sensing and reacting to damage. Nat Rev Immunol. 2010; 10(12): 826–37. doi: 10.1038/nri2873

  13. Skaper S., Facci L., Zusso M., Giusti P. Neuroinflammation, mast cells, and glia: dangerous liaisons. Neuroscientist. 2017; 23(5): 478–98. doi: 10.1177/1073858416687249.

  14. Guillemin G.J., Brew B.J. Microglia, macrophages, perivascular macrophages, and pericytes: a review of function and identification. J Leukoc Biol. 2004; 5(3): 388–97.

  15. Whitton P.S. Inflammation as a causative factor in the aetiology of Parkinson’s disease. Br J Pharmacol. 2007; 150(8): 963–76.

  16. Mracsko E., Javidi E., Na S.Y. et al. Leukocyte invasion of the brain after experimental intracerebral hemorrhage in mice. Stroke. 2014; 45(7): 2107–14. doi: 10.1161/STROKEAHA.114.005801.

  17. Almolda B., Gonzalez B., Castellano B. Are microglial cells the regulators of lymphocyte responses in the CNS? Front Cell Neurosci. 2015; 9: 440. doi: 10.3389/fncel.2015.00440.

  18. Hu X., Leak R.K., Shi J. et al. Microglial and macrophage polarization-new prospects for brain repair. Nat Rev Neurol. 2015; 11(1): 56–64. doi: 10.1038/nrneurol.2014.207.

  19. Клюшник Т.П., Андросова Л.В., Зозуля С.А. с соавт. Сравнительный анализ воспалительных маркеров при эндогенных и непсихотических психических расстройствах. Сибирский вестник психиатрии и наркологии. [Klyushnik T.P., Androsova L.V., Zozulya S.A. Comparative analysis of inflammatory markers in endogenous and non-psychotic mental disorders. 2018; 2(99): 64–69. Sibirsky vestnik psikhiatrii i narkologii. 2018; 2(99): 64–69 (In Russ.)]. doi: https://doi.org/10.26617/1810-3111-2018-2(99)-64-69.


About the Autors

Ella Yu. Solovieva, MD, professor of the Department of neurology of additional professional education of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityanova Str. Tel.: +7 (903) 549-05-18. E-mail: ellasolovieva@yandex.ru. ORCID ID: 0000-0003-1256-2695
Inna P. Amelina, assistant of the Department of neurology of additional professional education of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, 1 Ostrovityanova Str. Address: 117997, Moscow, 1 Ostrovityanova Str. Tel.: +7 (926) 409-13-83. E-mail: inna.filatova03@mail.ru. ORCID ID: 0000-0001-7434-1623
Olga A. Baranova, candidate of biological sciences, Senior researcher at the biomedical research laboratory of the Department of neurology of additional professional education of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, Russia, 1 Ostrovityanova Str.
Tel.: +7 (905) 769-66-47. E-mail: oabaranova@yandex.ru. ORCID ID: 0000-0001-9022-0426
Andrey V. Chekanov, candidate of biological sciences, Senior researcher at the biomedical research laboratory of the Department of neurology of additional professional education of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117997, Moscow, Russia, 1 Ostrovityanova Str. Tel.: +7 (968) 791-51-79. E-mail: avchekanov71@yandex.ru. ORCID ID: 0000-0001-7737-835X


Similar Articles

Back to Content

Бионика Медиа