title: Oxidative damage in ischemic stroke revealed using multiple biomarkers.
abstract: OBJECTIVE
  We investigated changes in oxidative damage after ischemic stroke using multiple biomarkers.
  
  
  METHODS
  Serial blood and urine samples of ischemic stroke subjects and age-matched control subjects were assayed for F₂-isoprostanes, hydroxyeicosatetraenoic acid products, F₄-neuroprostanes, 24-hydroxycholesterol, allantoin, and urate.
  
  
  RESULTS
  Sixty-six stroke subjects (mean age, 65 years; median National Institutes of Health Stroke Scale 17) and 132 control subjects were recruited. A bimodal pattern of change was observed in plasma and urinary F₂-isoprostanes and plasma 24-hydroxycholesterol. The rise in plasma hydroxyeicosatetraenoic acid products, F₄-neuroprostanes, and allantoin was highest 6 to 12 hours after stroke onset, whereas plasma urate was significantly lower than controls on Days 1 to 3. After adjusting for age and baseline National Institutes of Health Stroke Scale, baseline plasma esterified hydroxyeicosatetraenoic acid products (OR, 1.01; 95% CI, 1.01 to 1.02), plasma urate (1.01; 1.00 to 1.01), and plasma free F₄-neuroprostanes (2.73; 1.76 to 3.93) were associated with 90-day good functional recovery (modified Rankin Scale ≤1).
  
  
  CONCLUSIONS
  Multiple markers of oxidative damage are increased immediately after stroke and remain elevated for several days. Recognition of these temporal changes may help design better antioxidant treatment trials for acute ischemic stroke.
authors.affiliation: Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. raymond_seet@nus.edu.sg
authors.forename: Raymond C S
authors.initials: RC
authors.lastname: Seet
authors.forename: Chung-Yung J
authors.initials: CY
authors.lastname: Lee
authors.forename: Bernard P L
authors.initials: BP
authors.lastname: Chan
authors.forename: Vijay K
authors.initials: VK
authors.lastname: Sharma
authors.forename: Hock-Luen
authors.initials: HL
authors.lastname: Teoh
authors.forename: Narayanaswamy
authors.initials: N
authors.lastname: Venketasubramanian
authors.forename: Erle C H
authors.initials: EC
authors.lastname: Lim
authors.forename: Wan-Ling
authors.initials: WL
authors.lastname: Chong
authors.forename: Woan-Foon
authors.initials: WF
authors.lastname: Looi
authors.forename: Shan-Hong
authors.initials: SH
authors.lastname: Huang
authors.forename: Benjamin K C
authors.initials: BK
authors.lastname: Ong
authors.forename: Barry
authors.initials: B
authors.lastname: Halliwell
mesh_terms: D000368:Aged; D000481:Allantoin / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D002545:Brain Ischemia / Q000378:metabolism*; D028441:F2-Isoprostanes / Q000378:metabolism*; D005260:Female; D006801:Humans; D006888:Hydroxycholesterols / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D058632:Neuroprostanes / Q000378:metabolism; D010084:Oxidation-Reduction; D018384:Oxidative Stress / Q000502:physiology*; D020521:Stroke / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D028441:F2-Isoprostanes; D006888:Hydroxycholesterols; D058632:Neuroprostanes; D000481:Allantoin; C044563:24-hydroxycholesterol