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Polymorphonuclear leukocyte elastase in patients with stroke
1Service of Neurology, Hospital Clínic i Provincial, Barcelona, Spain.
Introduction/Objectives:
Polymorphonuclear leukocytes (PMNL) are involved in the pathogenesis of acute cerebral ischemia and atherosclerosis. Elastase is one of the proteolytic enzymes released by activated PMNL. We evaluated whether plasma levels of elastase-inhibitor complexes (EIC) are related to acute cerebral damage or with extension of carotid atherosclerosis in patients with stroke.
Methods:
Plasma levels of EIC were determined in 44 patients during acute and chronic phases of stroke. We recorded in all patients vascular risk factors, clinical severity on admission, infarct volume, and extension of carotid atherosclerosis using B-mode ultrasound exam.
Results:
EIC levels were not different between acute and chronic phases of stroke. Eleven patients (25%) had increased values of EIC. On multiple regression analysis diabetes, dislipemia, and coronary disease were predictors of abnormal EIC levels. EIC levels were not related to neurological severity on admission, infarct volume, or carotid atherosclerosis.
Conclusion:
EIC levels in stroke patients are associated to the presence of vascular risk factors and may reflect cellular inflammatory aspects of chronic vessel disease. However, whether elastase contributes to the development of carotid atherosclerosis in patients with stroke remains unknown.
Insights
Plasma elastase-inhibitor complexes (EIC) in stroke patients correlate with vascular risk factors like diabetes and dyslipidemia. However, EIC levels did not show a direct link to acute cerebral damage or the extent of carotid atherosclerosis.
Area of Science:
- Biomedical science
- Vascular biology
- Inflammation research
Background:
- Polymorphonuclear leukocytes (PMNL) play a role in acute cerebral ischemia and atherosclerosis.
- Elastase, released by activated PMNL, is implicated in these processes.
- Investigating elastase-inhibitor complexes (EIC) may offer insights into stroke pathogenesis.
Purpose of the Study:
- To determine if plasma EIC levels correlate with acute cerebral damage in stroke patients.
- To assess the relationship between plasma EIC levels and the extent of carotid atherosclerosis.
- To identify predictors of abnormal EIC levels in stroke patients.
Main Methods:
- Plasma EIC levels were measured in 44 stroke patients during acute and chronic phases.
- Vascular risk factors, clinical severity, infarct volume, and carotid atherosclerosis were assessed.
- B-mode ultrasound was used to evaluate carotid atherosclerosis extension.
Main Results:
- EIC levels did not differ between acute and chronic stroke phases.
- Elevated EIC levels were observed in 25% of patients.
- Diabetes, dyslipidemia, and coronary disease predicted abnormal EIC levels.
- EIC levels were not associated with neurological severity, infarct volume, or carotid atherosclerosis extent.
Conclusions:
- Stroke patient EIC levels are linked to vascular risk factors, potentially reflecting chronic inflammatory processes.
- The specific contribution of elastase to carotid atherosclerosis development in stroke patients remains undetermined.