title: Chronic Systemic Immune Dysfunction in African-Americans with Small Vessel-Type Ischemic Stroke.
abstract: The incidence of small vessel-type (lacunar) ischemic strokes is greater in African-Americans compared to whites. The chronic inflammatory changes that result from lacunar stroke are poorly understood. To elucidate these changes, we measured serum inflammatory and thrombotic biomarkers in African-Americans at least 6 weeks post-stroke compared to control individuals. Cases were African-Americans with lacunar stroke (n = 30), and controls were age-matched African-Americans with no history of stroke or other major neurologic disease (n = 37). Blood was obtained >6 weeks post-stroke and was analyzed for inflammatory biomarkers. Freshly isolated peripheral blood mononuclear cells were stimulated with lipopolysaccharide (LPS) to assess immune responsiveness in a subset of cases (n = 5) and controls (n = 4). After adjustment for covariates, the pro-inflammatory biomarkers, soluble vascular cadherin adhesion molecule-1 (sVCAM-1) and thrombin anti-thrombin (TAT), were independently associated with lacunar stroke. Immune responsiveness to LPS challenge was abnormal in cases compared to controls. African-Americans with lacunar stroke had elevated blood levels of VCAM-1 and TAT and an abnormal response to acute immune challenge >6 weeks post-stroke, suggesting a chronically compromised systemic inflammatory response.
authors.affiliation: Department of Neurobiology and Anatomy, Center for Basic and Translational Stroke Research, and Center for Neuroscience, West Virginia University School of Medicine, Box 9128, Morgantown, WV, 26506, USA. cdbrown2@hsc.wvu.edu.
authors.forename: Candice M
authors.initials: CM
authors.lastname: Brown
authors.affiliation: Department of Neurology, One Medical Center Boulevard, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA.
authors.forename: Cheryl D
authors.initials: CD
authors.lastname: Bushnell
authors.affiliation: Department of Biostatistics and Bioinformatics, Duke University Medical Center, Box 2721, Durham, NC, 27110, USA.
authors.forename: Gregory P
authors.initials: GP
authors.lastname: Samsa
authors.affiliation: Department of Neurology and Kentucky Neuroscience Institute, University of Kentucky, 740 S. Limestone Street, Room L445, Lexington, KY, 40536, USA.
authors.forename: Larry B
authors.initials: LB
authors.lastname: Goldstein
authors.affiliation: Department of Neurology, Duke University Medical Center, Box 2900, Durham, NC, 27710, USA.
authors.forename: Carol A
authors.initials: CA
authors.lastname: Colton
mesh_terms: D001741:Black or African American; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002545:Brain Ischemia / Q000097:blood* / Q000150:complications / Q000276:immunology*; D002908:Chronic Disease; D005260:Female; D015696:Gene Products, tat / Q000097:blood; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000209:etiology; D018836:Inflammation Mediators / Q000097:blood; D008297:Male; D008875:Middle Aged; D059409:Stroke, Lacunar / Q000097:blood* / Q000150:complications / Q000276:immunology*; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood
chemical_list: D015415:Biomarkers; D015696:Gene Products, tat; D018836:Inflammation Mediators; D019010:Vascular Cell Adhesion Molecule-1
keywords: African-Americans; Biomarkers; Chronic inflammation; Lacunar stroke; Race-ethnic disparities; Small vessel disease