role of neutrophils and interleukin-8 in acute ischemic stroke

To investigate the crucial role of interleukin 8 [IL-8] as an inflammatory marker in infarct evolution, and course of the disease. The study included 76 patients that were admitted to Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey between September 2001 and June 2002 with an initial diagnosis of acute ischemic stroke, and 28 control subjects with a corresponding mean age. The serum IL-8 levels obtained within 24 hours of the stroke were assessed by the enzyme-linked immunoabsorbent assay method. The patients were divided into 4 groups according to the extent, and localization of the ischemic lesions. Prognosis was evaluated by modified Rankin Scale. In comparison between patients and control groups, there was a statistically significant difference in [p<0.001] IL-8, and neutrophil [net] levels [p=0.000]. The serum IL-8 levels were associated with the extent of the lesion [p<0.01]. Though the serum IL-8 levels were significantly higher in the dependent group [p<0.05], there was no significant difference between net levels, and prognosis [p<0.05]. There was also no significant difference according to age, gender, and etiology between IL-8 and net levels. The high serum IL-8 levels are associated with prognosis. The development of new neuroprotective treatments aimed to prevent neutrophil-mediated-inflammation induced by IL-8 is critical in the treatment of stroke, and prevention of clinical worsening

Tumor necrosis factor alpha serum levels and inflammatory response in acute ischemic stroke

To assess the implication of tumor necrosis factor alpha [TNF-alpha] and interleukine-6 [IL-6] in acute ischemic stroke and to correlate this with lesion size, vascular risk factors, and neurological impairment. We included 70 patients consecutively admitted to the Department of 1st Neurology, Haydarpasa Numune Educational and Research Hospital, Istanbul, Turkey, between September 2001 and April 2002, with first-ever ischemic cerebral infarction within the first 24 hours from onset. The TNF-alpha, IL-6, fibrinogen, C-reactive protein, erythrocyte sedimentation rate [ESR] and leukocytes were determined in plasma on admission. Neurological impairment was evaluated with the modified Rankin Scale. We found higher baseline levels of TNF-alpha and IL-6 in the plasma of patients with acute ischemic stroke and neurological impairment in comparison to control subjects. In the large infarct group, TNF-alpha, IL-6, low-density lipoprotein-cholesterol and fibrinogen were found significantly higher compared to the small infarct group. While an association between TNF-alpha and IL-6 values and lesion size were determined, no relation was found between localization and etiology. The TNF-alpha level was found to be in positive correlation with IL-6, fibrinogen, and ESR. The IL-6 level was found to be in positive correlation with ESR fibrinogen, and leukocytes. Inflammatory findings are associated with the early stage of ischemic stroke. The TNF-alpha and IL-6 were also higher in patients with clinical worsening. The release of proinflammatory cytokines after focal cerebral ischemia indicates a step leading to tissue necrosis or reflects the amount of ischemic brain injury, since the higher concentrations of TNF-alpha and IL-6 are found in patients with large infarctions