Parameters of Systemic Inflammatory Response in Patients with Passing Infringements of Brain Blood Circulation

Aims: The paper aims at revealing the difference in the change of Systemic Inflammation (SI) parameters in blood plasma of patients with Passing Infringements of Brain Blood Circulation (PIBBC) and stroke during 10-day acute period.

Study Design: Prospective cohort study.

Place and Duration of Study: Department of Neurology and Neurosurgery of the Gomel State Medical University, Stroke Unit of the Gomel Regional Veterans Hospital, between May 2013 and March 2015.

Methodology: This study included 108 patients (35 men, 73 women; age range is 46-90 years) and 20 volunteers over 45 years (11 men, 9 women, mean age is 54.3±1.6 years). We compared the parameters of systemic inflammation (blood plasma concentrations of interleukins (IL-6, IL-8, IL-10), tumor necrosis factor α (TNFα), C-reactive protein (CRP) and stable metabolites of nitric oxide (nitrite- and nitrate-ions, NOx) in patients with PIBBC including transient ischemic attack (TIA) and cerebral hypertensive crisis (CHC), patients with lacunar stroke (LS) on the first and tenth day of patient staying in the hospital and in volunteers of a control group.

Results: On the first day, the IL-6 and CRP levels for PIBBC and LS groups was found to be significantly higher than the corresponding parameters for a control group. An increase in IL-6 level during the 10-day therapeutic period was observed only in blood plasma of the LS group persons. The TNF-α level was about zero level for all the studied groups except for the LS group on the tenth day. On the first day, for the patients with LS the IL-8 level was significantly decreased comparing to that for the control group and PIBBC groups and the NOx level was significantly lower than that for CHC group. Both parameters increased in values during the 10-day therapeutic period. No difference between the parameters (NOx and IL-8) for PIBBC and control groups was detected on the first day. Coefficient of reactivity characterizing the systemic inflammation level in patients of all the studied groups was nonzero level and it increased in the LS patients during the therapeutic period.

Conclusion: The obtained data showed an important role a number of inflammation markers (NOx, IL-6, IL-8, TNF-α, CRP) in the pathogenesis of different stroke episodes. Absence of specific neuroimaging changes in TIA and CHC group and nonzero coefficient of reactivity (kR) suggests that systemic inflammation is not a result of the focal brain ischemia but its intrinsic cause. The differences in the concentration of IL-8, and NOx in the blood plasma of patients with CHC and LS on their admission to the hospital will help to identify sanogenetic reserves in the case of PIBBC.