title: Endothelin in cerebrospinal fluid and plasma of patients in the early stage of ischemic stroke.
abstract: OBJECTIVE
  Endothelin 1 (ET-1), a highly potent endogenous vasoactive peptide, exerts a sustained vasoconstrictive effect on cerebral vessels. Elevation of ET-1 in plasma has been reported 1 to 3 days after ischemic stroke. Since we assumed that a much faster and more intense response may be observed in the cerebrospinal fluid (CSF) and since an increase in concentration of ET-1 in the CSF may cause constriction of cerebral vessels and eventually influence the neurological outcome, we measured ET-1 values in the CSF within 18 hours of stroke onset and compared the values with those in the plasma.
  
  
  METHODS
  Twenty-six consecutive patients with acute stroke were clinically evaluated according to the modified Matthew Scale and underwent two repeat CT scans. Within 5 to 18 hours of stroke onset, lumbar puncture and blood samples were concomitantly obtained and tested; ET-1 levels in CSF and plasma of these patients were analyzed by radioimmunoassay and compared with the levels of a control group of patients with no neurological disease.
  
  
  RESULTS
  The mean CSF concentration of ET-1 in the CSF of stroke patients was 16.06 +/- 4.9 pg/mL, compared with 5.51 +/- 1.47 pg/mL in the control group (P < .001). It was significantly higher in cortical infarcts (mean, 17.7 +/- 4.1 pg/mL) than in subcortical lesions (mean, 10.77 +/- 4.1 pg/mL) (P < .001) and significantly correlated with the volume of the lesion (P = .003). The correlation between ET-1 levels in the CSF and the Matthew Scale score was less significant (P = .05). Plasma ET-1 level was not elevated in any group.
  
  
  CONCLUSIONS
  ET-1 is found to be significantly elevated in the CSF of stroke patients during the 18 hours after stroke. No elevation was demonstrated in plasma at this time period. ET-1 may be used as an additional indicator of ischemic vascular events in the early diagnosis of stroke. The dissimilarity between the CSF and plasma ET-1 concentrations may lead also to an hypothesis that there is a vasoconstrictive effect on the cerebral vessels or a neuronal effect caused by ET-1 in the mechanism of the progression of brain ischemia.
authors.affiliation: Department of Neurology, Edith Wolfson Medical Center, Holon, Israel.
authors.forename: Y
authors.initials: Y
authors.lastname: Lampl
authors.forename: G
authors.initials: G
authors.lastname: Fleminger
authors.forename: R
authors.initials: R
authors.lastname: Gilad
authors.forename: R
authors.initials: R
authors.lastname: Galron
authors.forename: I
authors.initials: I
authors.lastname: Sarova-Pinhas
authors.forename: M
authors.initials: M
authors.lastname: Sokolovsky
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000097:blood* / Q000134:cerebrospinal fluid*; D002544:Cerebral Infarction / Q000097:blood / Q000134:cerebrospinal fluid / Q000000981:diagnostic imaging; D002561:Cerebrovascular Disorders / Q000097:blood* / Q000134:cerebrospinal fluid*; D016232:Endothelins / Q000097:blood* / Q000134:cerebrospinal fluid*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D013997:Time Factors; D014057:Tomography, X-Ray Computed
chemical_list: D016232:Endothelins