Related Experiment Video
Updated: Aug 22, 2025
Intrastriatal Injection of Autologous Blood or Clostridial Collagenase as Murine Models of Intracerebral Hemorrhage
Published on: July 3, 2014
Serum inflammatory cell adhesion molecules predict malignant cerebral edema and clinical outcome early after
Rongguo Hu1, Duyi Zhang1, Zhen Hu2
1Dept. of Neurology, Gongli Hospital, The Second Military Medical University, Shanghai 200135, PR China.
Background:
Early prediction of life-threatening malignant cerebral edema (MCE) after mechanical thrombectomy (MT) is of clinical importance. Although inflammatory cell adhesion molecules (CAMs) and anti-inflammation factor Kruppel-like transcription factor (KLF) 4 are induced after acute ischemic stroke (AIS), the relationship between expressions of these molecules after MT and MCE as well as outcome in AIS patients have rarely been explored.
Methods:
We retrospectively reviewed the data of all AIS patients with large-vessel occlusion in anterior circulation who underwent MT from our stroke centers. The serum levels of CAMs and KLF4 were determined at 12 h after MT. MCE was assessed on follow-up head computed tomography within 5 days after MT.
Results:
Of 91 included patients, 18 (19.8 %) patients experienced MCE. Patients with MCE were more likely to have higher levels of E-selectin and inter-cellular adhesion molecule 1 (ICAM-1) than those without MCE (P < 0.05). More specifically, elevated E-selectin, but not of vascular cell adhesion molecule 1 (VCAM-1), ICAM-1 and KLF4, was significantly associated with MCE after adjusting for hypertension, admission NIHSS, Alberta Stroke Program Early CT Scores, serum glucose, collateral circulation and onset to recanalization time respectively (P < 0.05). ROC curve suggested that E-selectin had considerable discrimination to predict MCE (AUC=0.7, 95 % CI: 0.55-0.83). Moreover, after adjusting by confounders, serum levels of E-selectin and ICAM-1 were independently associated with 3-month outcome in AIS patients after MT (both P < 0.05).
Conclusions:
These data indicate that of three CAMs, serum E-selectin level early after MT is the best predictor for MCE and outcome in AIS.
Insights
Serum E-selectin levels measured 12 hours after mechanical thrombectomy (MT) can predict malignant cerebral edema (MCE) and improve outcomes in acute ischemic stroke (AIS) patients.
Area of Science:
- Neurology
- Biochemistry
- Medical Diagnostics
Background:
- Malignant cerebral edema (MCE) is a life-threatening complication after mechanical thrombectomy (MT) for acute ischemic stroke (AIS).
- Cell adhesion molecules (CAMs) and Kruppel-like transcription factor (KLF) 4 are involved in post-stroke inflammation, but their role in MCE prediction after MT is underexplored.
Purpose of the Study:
- To investigate the association between serum levels of CAMs and KLF4 post-MT and the development of MCE in AIS patients.
- To determine if these molecular markers can predict MCE and patient outcomes after MT.
Main Methods:
- Retrospective analysis of AIS patients who underwent MT for large-vessel occlusion.
- Measurement of serum E-selectin, ICAM-1, VCAM-1, and KLF4 levels at 12 hours post-MT.
- Assessment of MCE via CT scans within 5 days and evaluation of 3-month outcomes.
Main Results:
- 19.8% of patients developed MCE.
- Elevated serum E-selectin and ICAM-1 levels were associated with MCE.
- Serum E-selectin demonstrated significant predictive value for MCE (AUC=0.7).
- E-selectin and ICAM-1 levels were independently associated with 3-month outcomes.
Conclusions:
- Serum E-selectin is a promising early biomarker for predicting MCE after MT in AIS.
- Elevated E-selectin and ICAM-1 levels are linked to poorer outcomes in AIS patients post-MT.
Related Concept Videos
01:17Intracellular Signaling Affects Focal Adhesions
Some...
01:31Immunoglobulin-like Cell Adhesion Molecules
Ig-CAMs exhibit either homophilic binding (to other Ig-CAMs) or heterophilic binding (to other ligands such as integrins). While most Ig-CAMs...