title: Interleukin-10 facilitates the selection of patients for systemic thrombolysis.
abstract: BACKGROUND
  Clinical-Diffusion mismatch (CDM; NIHSS score ≥8 & DWI lesion volume ≤25 mL) and Perfusion-Diffusion mismatch (PDM; difference >20% between initial DWI and MTT lesion volumes) have been proposed as surrogates for ischemic brains that are at risk of infarction. However, their utility to improve the selection of patients for thrombolytic treatment remains controversial. Our aim was to identify molecular biomarkers that can be used with neuroimaging to facilitate the selection of ischemic stroke patients for systemic thrombolysis.
  
  
  METHODS
  We prospectively studied 595 patients with ischemic stroke within 12 h of the stroke onset. A total of 184 patients received thrombolytic treatment according to the SITS-MOST criteria. DWI and MTT volumes were measured at admission. The main outcome variable was good functional outcome at 3 months (modified Rankin scale <3). Serum levels of glutamate (Glu), IL-10, TNF-α, IL-6, NSE, and active MMP-9 also were determined at admission.
  
  
  RESULTS
  Patients treated with t-PA who presented with PDM had higher IL-10 levels at admission (p < 0.0001). In contrast, patients with CDM had higher levels of IL-10 (p < 0.0001) as well as Glu and TNF-α (all p < 0.05) and lower levels of NSE and active MMP-9 (all p < 0.0001). IL-10 ≥ 30 pg/mL predicts good functional outcome at 3 months with a specificity of 88% and a sensitibity of 86%. IL-10 levels ≥30 pg/mL independently in both patients with PDM (OR, 18.9) and CDM (OR, 7.5), after an adjustment for covariates.
  
  
  CONCLUSIONS
  Serum levels of IL-10 facilitate the selection of ischemic stroke patients with CDM and PDM for systemic thrombolysis.
authors.forename: Manuel
authors.initials: M
authors.lastname: Rodríguez-Yáñez
authors.forename: Mar
authors.initials: M
authors.lastname: Castellanos
authors.forename: Tomás
authors.initials: T
authors.lastname: Sobrino
authors.forename: David
authors.initials: D
authors.lastname: Brea
authors.forename: Pedro
authors.initials: P
authors.lastname: Ramos-Cabrer
authors.forename: Salvador
authors.initials: S
authors.lastname: Pedraza
authors.forename: José A
authors.initials: JA
authors.lastname: Castiñeiras
authors.forename: Joaquín
authors.initials: J
authors.lastname: Serena
authors.forename: Antonio
authors.initials: A
authors.lastname: Dávalos
authors.forename: José
authors.initials: J
authors.lastname: Castillo
authors.forename: Miguel
authors.initials: M
authors.lastname: Blanco
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002545:Brain Ischemia / Q000097:blood / Q000188:drug therapy / Q000473:pathology; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D016753:Interleukin-10 / Q000097:blood*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D020521:Stroke / Q000097:blood / Q000188:drug therapy / Q000473:pathology; D015912:Thrombolytic Therapy / Q000379:methods / Q000592:standards*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*
chemical_list: D015415:Biomarkers; D005343:Fibrinolytic Agents; C508609:IL10 protein, human; D016753:Interleukin-10; D010959:Tissue Plasminogen Activator