title: Plasma α-melanocyte stimulating hormone predicts outcome in ischemic stroke.
abstract: OBJECTIVE
  α-Melanocyte stimulating hormone (α-MSH) is an endogenously produced neuropeptide derived from the same precursor as adrenocorticotropic hormone. α-MSH has profound immunomodulatory properties and may also be neuroprotective. Nothing is known about α-MSH and changes in its plasma concentrations in patients with acute ischemic stroke.
  
  
  METHODS
  In this prospective observational study, plasma concentrations of α-MSH, adrenocorticotropic hormone, cortisol, and interleukin 6 were assessed longitudinally over the course of 1 year after stroke onset in 111 patients. Logistic regression was used to the effect of initial plasma α-MSH, adrenocorticotropic hormone, cortisol, and interleukin 6 on long-term outcome.
  
  
  RESULTS
  There was an early decrease in plasma α-MSH in patients with severe stroke (National Institutes of Health Stroke Scale≥17) that normalized over the course of the year; these same patients evidenced elevations in plasma cortisol and interleukin 6. Higher initial plasma α-MSH, but not adrenocorticotropic hormone, cortisol, or interleukin 6, was independently predictive of good long-term outcome.
  
  
  CONCLUSIONS
  This research is the first to study endogenous changes in plasma α-MSH after stroke. The independent effect of early plasma α-MSH on stroke outcome, as well as a growing body of experimental data demonstrating improved stroke outcome with exogenous α-MSH administration, suggests a potential therapeutic role for α-MSH in the treatment of stroke.
authors.affiliation: Department of Neurology, University of Washington School of Medicine, Box 359775, Harborview Medical Center, 325 9th Ave, Seattle, WA 98104-2499, USA.
authors.forename: Dannielle
authors.initials: D
authors.lastname: Zierath
authors.forename: Pat
authors.initials: P
authors.lastname: Tanzi
authors.forename: Kevin
authors.initials: K
authors.lastname: Cain
authors.forename: Dean
authors.initials: D
authors.lastname: Shibata
authors.forename: Kyra
authors.initials: K
authors.lastname: Becker
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D002545:Brain Ischemia / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D020521:Stroke / Q000097:blood*; D000521:alpha-MSH / Q000097:blood*
chemical_list: D015850:Interleukin-6; D000521:alpha-MSH; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone