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Elevated plasma macrophage migration inhibitor factor as a risk factor for the development of post-stroke depression
Tingting Xu1, Shuang Pu2, Ying Ni3
1School of Clinical medicine of Weifang Medical College, Weifang, China.
Background:
Macrophage migration inhibitory factor (MIF), a central cytokine of the innate immunity and inflammatory responses, has been reported to link to the pathophysiology of cardiovascular disease and depression. The aim of this study was to test the possible association between plasma MIF and the development of post-stroke depression (PSD) in Chinese patients with acute ischemic stroke (AIS).
Methods:
The first-ever AIS patients who were hospitalized at Affiliated Hospital of Weifang Medical College during the period from November 2015 to September 2017 were included. Neurological and neuropsychological evaluations were conducted at the 3-month follow-up. Plasma concentrations of MIF were tested by Quantikine Human MIF Immunoassay. Plasma levels of homocysteine (HCY), C-reactive protein (CRP) and Interleukin 6 (IL-6) were also tested. Results were expressed as percentages for categorical variables and as medians (Interquartile range-IQR) for the continuous variables.
Results:
Finally, 333 stroke patients were included, and 95 out of those patients (28.5%) were classified as major depression. In the patients with major depression, plasma levels of MIF were higher compared with those in patients free-depression [27.3(IQR, 23.5-34.9) ng/ml vs. 20.9(IQR, 17.0-24.8) ng/ml; Z = 8.369, P < 0.001]. For each 1unit increase of MIF, the unadjusted and adjusted risk of PSD increased by 18% (odds ratios [OR]: 1.18; 95% confidence interval [CI], 1.13-1.23, P < 0.001) and 11% (1.11; 1.02-1.16, P = 0.001), respectively. In a multivariate model using the elevated levels of MIF (≥median) vs. normal (
Conclusion:
The present study demonstrated that elevated plasma levels of MIF at admission were associated with increased risk of PSD in the next three months and might be useful in identifying stroke at risk for PSD for early prevention strategies.
Insights
Elevated macrophage migration inhibitory factor (MIF) plasma levels in acute ischemic stroke patients are linked to a higher risk of developing post-stroke depression (PSD). This finding suggests MIF may aid in identifying individuals for early PSD prevention strategies.
Area of Science:
- Neuroscience
- Immunology
- Cardiovascular Medicine
Background:
- Macrophage migration inhibitory factor (MIF) is a key cytokine in innate immunity and inflammation.
- MIF has been implicated in the pathophysiology of cardiovascular disease and depression.
- The association between MIF and post-stroke depression (PSD) remains under investigation.
Purpose of the Study:
- To investigate the association between plasma MIF levels and the development of PSD in Chinese patients with acute ischemic stroke (AIS).
- To determine if MIF can serve as a predictive biomarker for PSD.
Main Methods:
- A cohort of 333 AIS patients was analyzed.
- Plasma MIF concentrations were measured using Quantikine Human MIF Immunoassay.
- Neurological and neuropsychological evaluations were conducted at 3-month follow-up to diagnose PSD.
Main Results:
- 28.5% of patients developed major depression within 3 months.
- Higher plasma MIF levels were observed in patients with PSD compared to those without.
- Increased MIF levels correlated with an elevated risk of PSD (OR: 1.18, P<0.001).
- MIF improved the predictive model for PSD, increasing the Area Under the Receiver Operating Characteristic curve (AUROC) from 0.81 to 0.86.
Conclusions:
- Elevated plasma MIF levels at admission are associated with an increased risk of developing PSD.
- MIF may be a valuable biomarker for identifying stroke patients at risk for PSD.
- Early identification can facilitate targeted prevention strategies for PSD.
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