title: Fetuin-A and CD40 L plasma levels in acute ischemic stroke: differences in relation to TOAST subtype and correlation with clinical and laboratory variables.
abstract: BACKGROUND
  Accumulating evidence suggests that inflammation plays an important role in the acute phase of ischemic stroke. CD40 L is a well recognized atherosclerotic inflammatory marker, whereas recent evidence suggests a pro-inflammatory role of Fetuin-A. To analyze the role of an inflammatory marker such as CD40 L and of a candidate pro-inflammatory marker such as Fetuin-A in acute stroke we evaluated their serum levels in subjects with acute ischemic stroke and their possible association with other laboratory and clinical variables.
  
  
  METHODS
  We enrolled 107 consecutive patients with a diagnosis of acute ischemic stroke admitted to the Internal Medicine Department at the University of Palermo between November 2006 and January 2008, and 102 hospitalized control patients without a diagnosis of acute ischemic stroke.
  
  
  RESULTS
  Patients with acute ischemic stroke in comparison to control subjects without acute ischemic stroke had significantly higher CD40 L levels and Fetuin-A serum levels. No significant differences in plasma CD40 L or Fetuin-A levels among different TOAST groups were detected. At intragroup (intra-TOAST-subtype) correlation analysis, among subjects classified as lacunar, CD40 L plasma levels were positively correlated with LDL-cholesterol and with diabetes, whereas Fetuin-A was significantly (positively) correlated with hypertension and white blood cell count. Among subjects with LAAS subtype, CD40 L levels were positively correlated with triglyceride plasma levels and Fetuin-A, whereas Fetuin-A levels were positively correlated with LDL-cholesterol.
  
  
  CONCLUSIONS
  Our findings suggest a pro-inflammatory role of Fetuin-A and CD40 L in acute stroke setting. Whether this role should be construed as direct or as a simple expression of a general inflammatory activation will be up to future studies to clarify.
authors.affiliation: Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Piazza delle Cliniche n.2, Palermo, Italy. brunotutto@unipa.it
authors.forename: A
authors.initials: A
authors.lastname: Tuttolomondo
authors.forename: D
authors.initials: D
authors.lastname: Di Raimondo
authors.forename: R
authors.initials: R
authors.lastname: Di Sciacca
authors.forename: A
authors.initials: A
authors.lastname: Casuccio
authors.forename: G
authors.initials: G
authors.lastname: Bivona
authors.forename: C
authors.initials: C
authors.lastname: Bellia
authors.forename: L
authors.initials: L
authors.lastname: Barreca
authors.forename: A
authors.initials: A
authors.lastname: Serio
authors.forename: G
authors.initials: G
authors.lastname: D'Aguanno
authors.forename: M
authors.initials: M
authors.lastname: Ciaccio
authors.forename: G
authors.initials: G
authors.lastname: Licata
authors.forename: A
authors.initials: A
authors.lastname: Pinto
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D001798:Blood Proteins / Q000032:analysis*; D002545:Brain Ischemia / Q000097:blood* / Q000145:classification* / Q000150:complications; D023201:CD40 Ligand / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000097:blood* / Q000145:classification* / Q000150:complications; D060749:alpha-2-HS-Glycoprotein
chemical_list: C556354:AHSG protein, human; D001798:Blood Proteins; D060749:alpha-2-HS-Glycoprotein; D023201:CD40 Ligand