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Selected serum cytokines and vitamin D levels as potential prognostic markers of acute ischemic stroke.
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- Author(s): Samarakoon N;Samarakoon N; Chang T; Chang T; Gunasekara V; Gunasekara V; Ratnayake P; Ratnayake P; Jayatillake R; Jayatillake R; Udagama P; Udagama P
- Source:
PloS one [PLoS One] 2024 Jun 13; Vol. 19 (6), pp. e0299631. Date of Electronic Publication: 2024 Jun 13 (Print Publication: 2024).- Publication Type:
Journal Article- Language:
English - Source:
- Additional Information
- Source: Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
- Publication Information: Original Publication: San Francisco, CA : Public Library of Science
- Subject Terms:
- 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-1β, 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-1β 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 Th1:Th2 cytokine (IFN-γ:IL-4) ratio occurred with AIS progression while a Th2 bias occurred during AIS recovery (p<0.05). Lower serum IL-1β 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 Th1:Th2 cytokine ratio (IFN-γ:IL-4), vitamin D status, history of stroke, and ischemic heart disease as significant predictors of AIS prognosis.
Competing Interests: The authors declare that no competing interests exist.
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BMJ. 2015 Oct 28;351:h5527. (PMID: 26511519) - Accession Number: 1406-16-2 (Vitamin D)
0 (Biomarkers)
0 (Cytokines)
207137-56-2 (Interleukin-4)
82115-62-6 (Interferon-gamma) - Publication Date: Date Created: 20240613 Date Completed: 20240613 Latest Revision: 20240615
- Publication Date: 20240615
- Accession Number: PMC11175438
- Accession Number: 10.1371/journal.pone.0299631
- Accession Number: 38870172
- Source:
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