Glycated serum protein is independently associated with progressive infarction in patients with acute ischemic stroke.

OBJECTIVE: This study investigated the relationship between glycated serum protein (GSP) and progressive infarction (PI). METHODS: From April 2017 to December 2020, we recruited 477 patients within 48 hours after the onset of acute ischemic stroke into this case-control study. Demographic characteristics, clinical information, and laboratory and neuroimaging data were recorded after admission. RESULTS: PI occurred in 144 (30.8%) patients. Patients with PI had higher initial National Institute of Health Stroke Scale (NIHSS) scores, higher discharge NIHSS scores, higher modified Rankin scale scores at 3 months after onset, higher GSP levels, lower prothrombin times, and lower creatinine levels than patients without PI. The likelihood of PI increased with increases in the GSP quartile. Multiple regression analysis revealed that high GSP levels (>2.14 mmol/L) were independently associated with PI. Subgroup analyses identified high GSP levels as an independent predictor of PI in patients with large artery atherosclerosis (third quartile: odds ratio [OR] = 3.793; 95% confidence interval [CI] = 1.555-9.250; fourth quartile: OR = 2.675; 95% CI = 1.056-6.776) and anterior circulation small vessel occlusion (fourth quartile: OR = 13.859; 95% CI = 2.024-94.885). CONCLUSIONS: GSP might be an independent predictor for PI in certain patients with acute ischemic stroke.

Rituximab-induced gut microbiota changes in Chinese neuromyelitis optica spectrum disorders.

BACKGROUND: Recent evidence shows that immunosuppressive agents can affect the gut microbiota in autoimmune diseases. However, the relationship between the gut microbiome and B-cell depletion immunotherapy in neuromyelitis optica spectrum disorder (NMOSD) remains poorly understood. OBJECTIVES: To evaluate the distinct intestinal microbial patterns and serum cytokine levels after short-term rituximab treatment (three months) in patients with NMOSD. METHODS: Firstly, we conducted a cross-sectional study involving 46 treatment-naïve NMOSD patients and 48 matched healthy controls. We collected fecal specimens, which were then analyzed using next-generation sequencing, and quantified serum cytokines. Subsequently, fecal and serum samples were re-collected and re-evaluated in 31 of the 46 treatment-naïve NMOSD patients after RTX treatment. RESULTS: Comparing the gut microbiome of treatment-naïve NMOSD patients to that of healthy controls revealed low α-diversity and distinct microbial compositions in the former. The microbial composition in NMOSD patients underwent changes following three months of RTX treatment. Specifically, the levels of IL-17F and IL-6 decreased, while those of IL-10 and TNFα increased after RTX treatment. LEfSe analysis identified 27 KEGG categories with significantly differential abundances between NMOSD patients and RTX treatment group. CONCLUSIONS: Our study provides a comprehensive understanding of the gut microbiota landscape in the context of B-cell depletion immunotherapy. We observed dysbiosis in the gut microbiome of NMOSD patients, which was partially alleviated by three months of RTX treatment. This suggests that B-cell depletion may play a crucial role in driving changes in the gastrointestinal environment.

Dyslipidemia is associated with progressive infarction in anterior circulation single subcortical infarction patients.

BACKGROUND: The predictors of progressive infarction (PI) in patients with anterior circulation single subcortical infarction (ACSSI) and pontine single infarction (PSI) may be different. Our study aims to evaluate the association between various lipid markers and PI in patients with ACSSI or PSI. METHODS: A total of 629 patients (546 patients diagnosed as ACSSI and 83 patients diagnosed as PSI) were retrospectively enrolled between January 2020 and October 2022. Seven lipid markers including total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-c), low density lipoprotein cholesterol (LDL-c), apolipoprotein A-I (ApoA-I), apolipoprotein B (ApoB) and lipoprotein(a) were collected within 24 h after admission. RESULTS: There were 119 patients with PI, accounting for 18.9% of the total. Univariate analysis showed that the levels of TC, TG, LDL-c, and ApoB in total patients with PI were higher than those in patients without PI (P < 0.05), while there were no significant differences in HDL-c, ApoA-I, and lipoprotein(a) (P > 0.05). In branch atheromatous disease patients, TC, TG, and ApoA-I were independently associated with PI after adjusting some confounding factors. Additionally, multivariate logistic regression analysis of the infarct location subgroup demonstrated TG and LDL-c were related to PI in patients with ACSSI (P < 0.05) but not in patients with PSI. Furthermore, receiver operating characteristic curves were established to compare the predictive abilities of TC, TG, LDL-c, and ApoB, and demonstrated TG was a better indicator to predict PI in ACSSI patients compared to other lipid markers. CONCLUSION: TG and LDL-c are associated with progressive infarction in patients with ACSSI, and TG was a superior predictor for PI compared to other lipid markers.