Inflammatory risk factors, biomarkers and associated therapy in ischaemic stroke

被引:235
作者
Esenwa, Charles C. [1 ]
Elkind, Mitchell S. [1 ]
机构
[1] Columbia Univ, Coll Phys & Surg, Neurol Inst, Dept Neurol, 710 West 168th St, New York, NY 10032 USA
关键词
C-REACTIVE PROTEIN; CORONARY-HEART-DISEASE; PHOSPHOLIPASE A(2) ACTIVITY; SMALL-VESSEL DISEASE; CARDIOVASCULAR-DISEASE; CHLAMYDIA-PNEUMONIAE; VASCULAR INFLAMMATION; INFLUENZA VACCINATION; INFECTIOUS BURDEN; TNF-ALPHA;
D O I
10.1038/nrneurol.2016.125
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Proinflammatory conditions, including acute and chronic infections, have been associated with an increased risk of stroke. The risk of stroke is increased by both the acute and chronic phases of a wide spectrum of proinflammatory conditions, suggesting that the association is related to activation of the inflammatory response rather than the condition itself. Different inflammatory mechanisms probably influence the risk of different stroke subtypes. This hypothesis is supported by observations that high levels of various immune system markers and acute phase reactants in otherwise healthy individuals have also been associated with ischaemic stroke subtypes. C-reactive protein, IL-6 and lipoprotein-associated phospholipase A2 are some of the inflammatory markers that have been associated with stroke risk and prognosis. Multiple epidemiological studies have demonstrated that these markers are associated with the risk of stroke, but the value of these markers in a clinical setting has not yet been proven. Further research is needed to determine whether immune system modulators can lower the risk of stroke in individuals with elevated concentrations of inflammatory markers. Here, we review the association between infection, systemic inflammation, and ischaemic stroke, and discuss the currently recommended preventive methods to decrease the risk of stroke associated with systemic inflammation.
引用
收藏
页码:594 / 604
页数:11
相关论文
共 142 条
[1]   CLASSIFICATION OF SUBTYPE OF ACUTE ISCHEMIC STROKE - DEFINITIONS FOR USE IN A MULTICENTER CLINICAL-TRIAL [J].
ADAMS, HP ;
BENDIXEN, BH ;
KAPPELLE, LJ ;
BILLER, J ;
LOVE, BB ;
GORDON, DL ;
MARSH, EE ;
KASE, CS ;
WOLF, PA ;
BABIKIAN, VL ;
LICATAGEHR, EE ;
ALLEN, N ;
BRASS, LM ;
FAYAD, PB ;
PAVALKIS, FJ ;
WEINBERGER, JM ;
TUHRIM, S ;
RUDOLPH, SH ;
HOROWITZ, DR ;
BITTON, A ;
MOHR, JP ;
SACCO, RL ;
CLAVIJO, M ;
ROSENBAUM, DM ;
SPARR, SA ;
KATZ, P ;
KLONOWSKI, E ;
CULEBRAS, A ;
CAREY, G ;
MARTIR, NI ;
FICARRA, C ;
HOGAN, EL ;
CARTER, T ;
GURECKI, P ;
MUNTZ, BK ;
RAMIREZLASSEPAS, M ;
TULLOCH, JW ;
QUINONES, MR ;
MENDEZ, M ;
ZHANG, SM ;
ALA, T ;
JOHNSTON, KC ;
ANDERSON, DC ;
TARREL, RM ;
NANCE, MA ;
BUDLIE, SR ;
DIERICH, M ;
HELGASON, CM ;
HIER, DB ;
SHAPIRO, RA .
STROKE, 1993, 24 (01) :35-41
[2]   Socioeconomic and psychosocial gradients in cardiovascular pathogen burden and immune response: The multi-ethnic study of atherosclerosis [J].
Aiello, Allison E. ;
Diez-Roux, Ana ;
Noone, Anne-Michelle ;
Ranjit, Nalini ;
Cushman, Mary ;
Tsai, Michael Y. ;
Szklo, Moyses .
BRAIN BEHAVIOR AND IMMUNITY, 2009, 23 (05) :663-671
[3]   Effects of antibiotic therapy on outcomes of patients with coronary artery disease - A meta-analysis of randomized controlled trials [J].
Andraws, R ;
Berger, JS ;
Brown, DL .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2005, 293 (21) :2641-2647
[4]  
[Anonymous], 2015, COCHRANE DATABASE SY, DOI DOI 10.1002/14651858.CD005050.PUB3
[5]   Multiple roles of the coagulation protease cascade during virus infection [J].
Antoniak, Silvio ;
Mackman, Nigel .
BLOOD, 2014, 123 (17) :2605-2613
[6]   Progression of symptomatic intracranial large artery atherosclerosis is associated with a proinflammatory state and impaired fibrinolysis [J].
Arenillas, Juan F. ;
Alvarez-Sabin, Jose ;
Molina, Carlos A. ;
Chacon, Pilar ;
Fernandez-Cadenas, Israel ;
Ribo, Marc ;
Delgado, Pilar ;
Rubiera, Marta ;
Penalba, Anna ;
Rovira, Alex ;
Montaner, Joan .
STROKE, 2008, 39 (05) :1456-1463
[7]   Lipoprotein-associated phospholipase A2, high-sensitivity C-reactive protein, and risk for incident ischemic stroke in middle-aged men and women in the Atherosclerosis Risk in Communities (ARIC) study [J].
Ballantyne, CM ;
Hoogeveen, RC ;
Bang, H ;
Coresh, P ;
Folsom, AR ;
Chambless, LE ;
Myerson, M ;
Wu, KK ;
Sharrett, AR ;
Boerwinkle, E .
ARCHIVES OF INTERNAL MEDICINE, 2005, 165 (21) :2479-2484
[8]   Linkage of large-vessel carotid atherosclerotic stroke to inflammatory genes via a systematic screen [J].
Belfer, Inna ;
Wu, Tianxia ;
Hipp, Heather ;
Walter, Joan ;
Scully, Michele ;
Nyquist, Paul A. ;
Bollettino, Antonella ;
Goldman, David ;
Max, Mitchell B. ;
DeGraba, Thomas J. .
INTERNATIONAL JOURNAL OF STROKE, 2010, 5 (03) :145-151
[9]   High serum C-reactive protein level is not an independent predictor for stroke - The Rotterdam Study [J].
Bos, Michiel J. ;
Schipper, C. Maarten A. ;
Koudstaal, Peter J. ;
Witteman, Jacqueline C. M. ;
Hofman, Albert ;
Breteler, Monique M. B. .
CIRCULATION, 2006, 114 (15) :1591-1598
[10]   Antibiotic treatment of Chlamydia pneumoniae after acute coronary syndrome [J].
Cannon, CP ;
Braunwald, E ;
McCabe, CH ;
Grayston, JT ;
Muhlestein, B ;
Giugliano, RP ;
Cairns, R ;
Skene, AM .
NEW ENGLAND JOURNAL OF MEDICINE, 2005, 352 (16) :1646-1654