Open AccessInflammatory mediator expression within retrieved clots in acute ischemic stroke
Author(s) -
Baek Byung Hyun,
Kim Hyung Seok,
Yoon Woong,
Lee Yun Young,
Baek Jang Mi,
Kim Eun Hee,
Kim Seul Kee
Publication year - 2018
Publication title -
annals of clinical and translational neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.824
H-Index - 42
ISSN - 2328-9503
DOI - 10.1002/acn3.529
Subject(s) - medicine , mediator , inflammatory mediator , ischemic stroke , stroke (engine) , expression (computer science) , inflammation , bioinformatics , intensive care medicine , ischemia , cardiology , mechanical engineering , engineering , computer science , biology , programming language
Objective In this study we investigate the association between the expression of inflammatory mediators measured in clots retrieved by mechanical thrombectomy, stroke etiology, and the susceptibility vessel sign ( SVS ) on gradient‐echo ( GRE ) MR imaging in acute ischemic stroke patients. Methods We performed molecular analysis of intracranial clots retrieved by mechanical thrombectomy from 82 patients with acute stroke. Seventy‐two of these patients underwent GRE imaging before endovascular therapy. We measured the relative expression of inflammatory mediators by performing the quantitative real‐time polymerase chain reaction on the retrieved clots and assessed associations between the expression of inflammatory mediators and stroke subtypes as well as with GRE SVS . Results Classifications of stroke etiology for the cohort were as follows: cardioembolism (51, 62.2%), large artery atherosclerosis (9, 11%), and undetermined etiology (22, 26.8%). Clots associated with large artery atherosclerosis showed significantly higher interleukin ( IL )‐1 β expression than clots from both cardioembolism and undetermined etiology ( P = 0.008). A positive SVS was identified in 48 of 72 patients (66.7%) who had GRE imaging. IL ‐1 β , tumor necrosis factor‐ α , and matrix metalloproteinase‐9 expressions were significantly higher in clots with a negative SVS than in those with a positive SVS ( P = 0.010, 0.049, and 0.004, respectively). Interpretation Expression of inflammatory mediators in intracranial clots differs significantly based on stroke etiology or presence or the absence of SVS on GRE imaging. This study suggests that molecular analysis of inflammatory mediators in retrieved clots is a promising tool for determining stroke mechanism in acute ischemic stroke patients.