Изменения цитокинового статуса при разных подтипах ишемического инсульта в остром периоде

Purpose The aim of this study was to assess a different pattern of inflammatory mediators in relation of ischemic stroke subtypes in acute period. Materials and Methods. The study involved 482 patients with different ischemic stroke (IS) subtypes. We studied the content of inflammatory interleukins (IL-1β, IL-2, IL-6, IL-8, CRP, TNF-α) and anti-inflammatory interleukin IL-10 in blood serum. Results The study revealed increasing content of pro-inflammatory cytokines in acute period of IS subtypes, especially at Large Artery AtheroSclerosis (LAAS) and CardioEmbolic Infarct (CEI). In patients with LAAS the level of IL-2, IL-6 and CRP was significantly higher compared to other IS subtypes. The content of IL-10 was significantly lower compared to patients with Undetermined Etiology (UDE) stroke and LACunar (LAC) stroke. We established the relationship between the concentration of IL-1β and IL-6 with the severity of LAAS, CEI and UDE on the 1 st day of stroke. On the 7 th day the concentration of IL-1β and IL-8 was significantly decreased at LAC, IL-2 – at LAC and LAAS, IL-6 and TNF-α at LAC and UDE. At LAAS the content of inflammatory mediators depended on the degree of arteries stenosis, the presence of unstable atherosclerotic plaques, the intima-media thickness. We found a direct relationship between the severity of LAAS and CEI on the 14 th day with the CRP concentration on the 1 st day (at LAAS – (r = 0.73, p = 0.003), at CEI – (r = 0.71, p = 0.002), indicating predictive value of CRP-content on the course of acute period of IS subtypes. We established the dependence between cardiac morphometric parameters with the level of pro-inflammatory interleukins in acute period of UDE. We found the relation between the content of IL-1β, IL-6 with left ventricular myocardial mass index at UDE. Conclusions The content of inflammatory mediators in acute period of ischemic stroke depends on the pathogenic subtype of stroke.