title: Inter-alpha-trypsin inhibitor heavy chain 4 is a novel marker of acute ischemic stroke.
abstract: BACKGROUND
  Inflammation and inflammatory markers play an important role in acute ischemic stroke (AIS). In an earlier study, we discovered a 120-kDa protein that was highly expressed in healthy participants, but either was not expressed or was barely expressed in AIS patients. The purpose of the present work was to isolate, characterize, and evaluate this 120-kDa protein in blood samples of AIS patients. In addition, we investigated how the identified protein compared with protein S-100betabeta, neuron-specific enolase (NSE), and cytokine interleukins IL-2 and IL-10.
  
  
  METHODS
  The 120-kDa protein band was analyzed via LC-MS/MS analysis. Then, the 120-kDa protein was evaluated using an enzyme-linked immunosorbant assay in serum samples from AIS patients, which were collected 0, 24, 48, 72 and 144 h after admission.
  
  
  RESULTS
  The amino acid sequence of an internal fragment identified the 120-kDa protein as inter-alpha-trypsin inhibitor heavy chain 4 (ITIH4). The ITIH4 protein was completely absent in AIS patients as compared to those in the control group, and serum levels returned to normal in AIS patients as their condition improved. Expression of S-100 betabeta, NSE, IL-2, and IL-10 were highly correlated with ITIH4 expression.
  
  
  CONCLUSIONS
  ITIH4 is an anti-inflammatory protein, and suggests that further investigation into its potential use in the diagnosis and prognosis of AIS is warranted.
authors.affiliation: Biochemistry Research Laboratory, Central India Institute of Medical Sciences, 88/2 Bajaj Nagar Nagpur-10, India.
authors.forename: Rajpal S
authors.initials: RS
authors.lastname: Kashyap
authors.forename: Amit R
authors.initials: AR
authors.lastname: Nayak
authors.forename: Poonam S
authors.initials: PS
authors.lastname: Deshpande
authors.forename: Dinesh
authors.initials: D
authors.lastname: Kabra
authors.forename: Hemant J
authors.initials: HJ
authors.lastname: Purohit
authors.forename: Girdhar M
authors.initials: GM
authors.lastname: Taori
authors.forename: Hatim F
authors.initials: HF
authors.lastname: Daginawala
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001798:Blood Proteins; D002545:Brain Ischemia / Q000097:blood* / Q000150:complications*; D002853:Chromatography, Liquid; D005260:Female; D006023:Glycoproteins / Q000097:blood*; D006801:Humans; D016753:Interleukin-10 / Q000097:blood; D007376:Interleukin-2 / Q000097:blood; D008297:Male; D008875:Middle Aged; D010751:Phosphopyruvate Hydratase / Q000097:blood; D053491:Proteinase Inhibitory Proteins, Secretory / Q000097:blood*; D009418:S100 Proteins / Q000097:blood; D020521:Stroke / Q000097:blood / Q000175:diagnosis*; D053719:Tandem Mass Spectrometry
chemical_list: D015415:Biomarkers; D001798:Blood Proteins; D006023:Glycoproteins; C508609:IL10 protein, human; C508594:IL2 protein, human; C091236:ITIH4 protein, human; D007376:Interleukin-2; D053491:Proteinase Inhibitory Proteins, Secretory; D009418:S100 Proteins; D016753:Interleukin-10; D010751:Phosphopyruvate Hydratase