Chitotriosidase in patients with acute ischemic stroke.
BACKGROUND
Following an acute brain ischemia, local endothelia allow monocyte chemoattraction into the lesion site which contributes to brain damage through a group of neurotoxic factors. A relationship exists between the extent of brain damage and the plasma level of monocyte products, including chitotriosidase, though usually strictly related to preexisting infectious-inflammatory diseases.


OBJECTIVE
Since chitotriosidase activity is also elevated in pathogen-free conditions, we tested whether chitotriosidase upregulation might be specifically related to stroke and unrelated to clinically relevant infectious diseases.


METHODS
We studied the plasma level of chitotriosidase activity, TNF-alpha and IL-6 in 44 consecutive patients with acute brain ischemia without concomitant symptoms or signs of inflammatory-infectious diseases. Results were compared with stroke severity and outcome as detected by brain CT and NIH scale. Blood samples were collected, on average, 11 h after stroke onset.


RESULTS
Chitotriosidase activity positively correlates with stroke severity, as measured by NIH scale (r = 0.69, p < 0.01), to the extent of brain damage as documented by CT (r = 0.75, p < or = 0.001) and the TNF-alpha level (r = 0.76, p < 0.001); it also inversely correlates with the IL-6 level (r = -0.43, p < or = 0.05).


CONCLUSIONS
Our results indicate that chitotriosidase is a specific marker of macrophage activation occurring in stroke which directly correlates with stroke severity independently of preexisting inflammatory or infectious conditions.
Sotgiu
Stefano
S
Institute of Clinical Neurology, University of Sassari, Italy. stefanos@uniss.it
Barone
Rita
R
Zanda
Bastianina
B
Arru
Giannina
G
Fois
M Laura
ML
Arru
Antonello
A
Rosati
Giulio
G
Marchetti
Bianca
B
Musumeci
Salvatore
S
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D002545:Brain Ischemia / Q000201:enzymology*; D005260:Female; D006596:Hexosaminidases / Q000097:blood*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000097:blood; D011446:Prospective Studies; D020521:Stroke / Q000000981:diagnostic imaging / Q000201:enzymology*; D014057:Tomography, X-Ray Computed; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D015415:Biomarkers; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D006596:Hexosaminidases; C086400:chitotriosidase