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Published on: September 22, 2020
Bone marrow-derived progenitor cells in the early phase of ischemic stroke: relation with stroke severity and
Francesca Cesari1, Patrizia Nencini, Mascia Nesi
1Department of Medical and Surgical Critical Care, Thrombosis Centre, University of Florence, Florence, Italy. francesca.cesari@gmail.com
Insights
Circulating progenitor cells (CPCs) are linked to stroke severity and recovery in ischemic stroke patients. Higher CPC levels correlate with better outcomes and less severe strokes, suggesting their potential as a biomarker.
Area of Science:
- Neuroscience
- Regenerative Medicine
- Hematology
Background:
- Previous studies indicate a negative correlation between circulating progenitor cells (CPCs) and stroke severity/outcomes in ischemic stroke patients.
- Endothelial progenitor cells (EPCs) are a subset of CPCs, and their role in stroke recovery requires further investigation.
Purpose of the Study:
- To simultaneously measure CPCs and EPCs in the acute phase of ischemic stroke.
- To determine the relationship between CPC/EPC levels, stroke severity (NIH Stroke Scale), and discharge outcomes.
Main Methods:
- Flow cytometry was used to quantify CPCs and EPCs in 67 acute ischemic stroke patients.
- Measurements were analyzed against baseline NIH Stroke Scale scores, stroke syndromes, and discharge disposition (home vs. rehabilitation unit).
Main Results:
- Patients with partial anterior circulation syndrome had higher CPC numbers than those with total anterior circulation syndrome.
- A negative correlation was observed between admission NIH Stroke Scale score and CPC count.
- Higher CPC numbers were associated with discharge to home compared to rehabilitation, while EPC numbers showed no significant difference.
Conclusions:
- The number of CPCs in the early phase of ischemic stroke is associated with neurological severity.
- CPC levels correlate with discharge outcomes, suggesting their potential as a prognostic biomarker in stroke patients.
Abstract:
A limited number of studies suggested that in ischemic stroke patients, the number of bone marrow circulating progenitor cells (CPCs), either endothelial progenitor cells (EPCs) or CPCs, was negatively correlated with the number of infarcts as well as with the outcome. The aim of this study was to simultaneously measure CPCs and EPCs in the acute phase of ischemic stroke, and to establish whether a relationship exists with stroke severity and discharge outcome. In 67 (40 M; 27 F) ischemic stroke patients with a median age of 73 (21 to 91) years, the number of CPCs and EPCs was measured by flow cytometry and analyzed in relation to baseline NIH Stroke Scale score, ischemic stroke syndromes, and discharge outcome. Patients with partial anterior circulation syndrome showed a higher CPCs' number with respect to patients with total anterior circulation syndrome. Moreover, a negative relationship between National Institutes of Health Stroke Scale score at the admission and CPCs number was observed. When the outcome was considered, patients discharged to home had a higher number of CPCs, but not of EPCs, compared with those moved to a rehabilitation unit. We report an association between the number of CPCs measured in the early phase after stroke presentation, neurologic severity, and discharge outcome.
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