The temporal dynamics of plasma fractalkine levels in ischemic stroke: association with clinical severity and outcome.
BACKGROUND
The chemokine fractalkine (CX3CL1, FKN) is involved in neural-microglial interactions and is regarded as neuroprotective according to several in vivo studies of inflammatory and degenerative states of the brain. Recently, an association with outcome in human ischemic stroke has been proposed. In this study, we aimed to investigate the temporal pattern of FKN levels in acute ischemic stroke in relation to stroke severity and outcome.


METHODS
FKN levels were measured in plasma specimens of fifty-five patients with acute ischemic stroke. Blood was available for time points 6 hours (h), 12 h, 3 days (d), 7 d and 90 d after stroke onset. Clinical outcome was evaluated using the modified Rankin Scale (mRS) at 7 d and 90 d.


RESULTS
The time course of FKN significantly differs depending on stroke severity, with higher FKN levels linked to a lower severity. FKN levels in patients with moderate to severe strokes differ significantly from controls. In outcome analysis, we found an association of dynamics of FKN with clinical outcome. Decrease of FKN is pronounced in patients with worse outcome. Multivariate analysis including stroke severity and stroke etiology revealed that deltaFKN between 6 h and 3 d is independently associated with mRS at 90 d. In addition deltaFKN is inversely correlated with the extent of brain damage, as measured by S100B.


CONCLUSIONS
FKN dynamics are independently associated with stroke outcome. Further studies might give insight on whether FKN is actively involved in the inflammatory cascade after acute ischemic stroke.
Gerrit M
GM
Grosse
Anita B
AB
Tryc
Meike
M
Dirks
Ramona
R
Schuppner
Henning
H
Pflugrad
Ralf
R
Lichtinghagen
Karin
K
Weissenborn
Department of Neurology, Hannover Medical School, Carl-Neuberg-Str, 1, 30625 Hannover, Germany. Worthmann.Hans@mh-hannover.de.
Hans
H
Worthmann
D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000209:etiology; D054428:Chemokine CX3CL1 / Q000097:blood*; D005260:Female; D006801:Humans; D007511:Ischemia / Q000150:complications; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017711:Nonlinear Dynamics; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013223:Statistics as Topic; D020521:Stroke / Q000097:blood* / Q000209:etiology; D013997:Time Factors
C515538:CX3CL1 protein, human; D054428:Chemokine CX3CL1