title: Association between plasma levels of hyaluronic acid and functional outcome in acute stroke patients.
abstract: BACKGROUND
  Activation of hyaluronic acid (HA) and associated enzyme synthesis has been demonstrated in experimental stroke animal models. Our study aimed to investigate the plasma levels of HA in acute stroke patients and the associations between HA levels and functional outcome.
  
  
  METHODS
  This was a multicenter case-control study. Acute stroke patients and age- and sex-matched non-stroke controls were recruited. Plasma levels of HA in acute stroke patients were determined at <48 hours and at 48 to 72 hours after stroke onset by standard ELISA. Favorable functional outcome was defined as modified Rankin scale ≤ 2 at 3 months after stroke.
  
  
  RESULTS
  The study included 206 acute stroke patients, including 43 who had intracerebral hemorrhage and 163 who had ischemic stroke, and 159 controls. The plasma levels of HA in the acute stroke patients were significantly higher than those in the controls (219.7 ± 203.4 ng/ml for <48 hours and 343.1 ± 710.3 ng/ml for 48 to 72 hours versus 170.4 ± 127.9 ng/ml in the controls; both P  <  0.05). For intracerebral hemorrhage patients, HA ≤ 500 ng/ml (<48 hours) was an independent favorable outcome predictor (P = 0.016). For ischemic stroke patients, an inverted U-shaped association between plasma HA (48 to 72 hours) and outcome was noted, indicating that ischemic stroke patients with too high or too low plasma HA levels tended to have an unfavorable outcome.
  
  
  CONCLUSIONS
  HA plasma level was elevated in patients with acute stroke, and can predict 3-month functional outcome, particularly for patients with intracerebral hemorrhage.
authors.forename: Sung-Chun
authors.initials: SC
authors.lastname: Tang
authors.forename: Shin-Joe
authors.initials: SJ
authors.lastname: Yeh
authors.forename: Li-Kai
authors.initials: LK
authors.lastname: Tsai
authors.forename: Chaur-Jong
authors.initials: CJ
authors.lastname: Hu
authors.forename: Li-Ming
authors.initials: LM
authors.lastname: Lien
authors.forename: Giia-Sheun
authors.initials: GS
authors.lastname: Peng
authors.forename: Wei-Shiung
authors.initials: WS
authors.lastname: Yang
authors.forename: Hung-Yi
authors.initials: HY
authors.lastname: Chiou
authors.affiliation: Stroke Center and Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan. jsjeng@ntu.edu.tw.
authors.forename: Jiann-Shing
authors.initials: JS
authors.lastname: Jeng
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D020521:Stroke / Q000097:blood* / Q000150:complications; D013624:Taiwan; D013997:Time Factors
chemical_list: D006820:Hyaluronic Acid