Leukocyte activation detected by increased plasma levels of inflammatory mediators in patients with ischemic cerebrovascular diseases

Background and Purpose: Leukocytes have been implicated in the development of ischemia atherosclerotic vascular disease. In a prospective study we investigated whether the plasma concentration of inflammatory mediator, ie, proteases and cytokine, as markers for systemic leukocyte activation, are increased in patient with acute ischemic cerebrovascular diseases. Methods: Using enzyme-linked immunosorbent assays, we measured the plasma level of neutrophil gelatinase-associated lipocalin (NGAL), neutrophil proteinase 4 (NP4), tumor necrosis factor-α (TNF)m and soluble TNF receptor protein-1 p55 (sTNFR-1) in 120 patients with acute ischemic cerebrovascular insult (72 with and 48 stroke and 48 with transient ischemic attack (TIAl) and in 35 age-and sex-matched healthy subject. Results: Compared with the control group, plasma NGAL levels were higher in the stroke group (P<.0001) and the TIA group (P<.01); plasma NP4 levels were higher in the stroke group (P<.0001) and the TIA group (P<.01); and plasma sTNFR-1 levels wee higher in the stroke group (P<.04). There was significant correlation between the plasma levels of fibrinogen and those of both sTNFR-1 (r=.32; P=32; P=.005) and NGAL 9r=.40; P=.0001) and between the erythrocyte sedimentation rate and the plasma levels of both sTNFR-1 (r=.35; P=.001) and NGAL (r=.34;P=.002). Conclusions: Our study demonstrated that marker for systemic leukocyte activation, ie, plasma levels of cytokine and protease, were higher in patients with acute ischemic cerebrovascular disease than in healthy control subject. Activated leukocytes and leukocytic mediator may have an important role in acute cerebrovascular ischemia and it consequences