Peak plasma interleukin-6 and other peripheral markers of inflammation in the first week of ischaemic stroke correlate with brain infarct volume, stroke severity and long-term outcome.
BACKGROUND
Cerebral ischaemia initiates an inflammatory response in the brain and periphery. We assessed the relationship between peak values of plasma interleukin-6 (IL-6) in the first week after ischaemic stroke, with measures of stroke severity and outcome.


METHODS
Thirty-seven patients with ischaemic stroke were prospectively recruited. Plasma IL-6, and other markers of peripheral inflammation, were measured at pre-determined timepoints in the first week after stroke onset. Primary analyses were the association between peak plasma IL-6 concentration with both modified Rankin score (mRS) at 3 months and computed tomography (CT) brain infarct volume.


RESULTS
Peak plasma IL-6 concentration correlated significantly (p < 0.001) with CT brain infarct volume (r = 0.75) and mRS at 3 months (r = 0.72). It correlated similarly with clinical outcome at 12 months or stroke severity. Strong associations were also noted between either peak plasma C-reactive protein (CRP) concentration or white blood cell (WBC) count, and all outcome measures.


CONCLUSIONS
These data provide evidence that the magnitude of the peripheral inflammatory response is related to the severity of acute ischaemic stroke, and clinical outcome.
Smith
Craig J
CJ
University of Manchester, Manchester M13 9PT, UK. csmith@fs1.ho.man.ac.uk
Emsley
Hedley C A
HC
Gavin
Carole M
CM
Georgiou
Rachel F
RF
Vail
Andy
A
Barberan
Elisa M
EM
del Zoppo
Gregory J
GJ
Hallenbeck
John M
JM
Rothwell
Nancy J
NJ
Hopkins
Stephen J
SJ
Tyrrell
Pippa J
PJ
D000368:Aged; D015415:Biomarkers / Q000097:blood; D001799:Blood Sedimentation; D001831:Body Temperature; D020520:Brain Infarction / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging; D002545:Brain Ischemia / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging; D018450:Disease Progression; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007249:Inflammation / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood*; D007958:Leukocyte Count; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging; D015996:Survival Rate; D014057:Tomography, X-Ray Computed
D015415:Biomarkers; D015850:Interleukin-6; D006854:Hydrocortisone