脓毒症患者外周血祖细胞和内皮祖细胞数量的变化

目的 检测脓毒症患者外周血单个核细胞(peripheral blood mononuelear cell,PBMC)中祖细胞和血管内皮祖细胞(endothelial progenitor cells,EPC)相对数量的变化,探讨感染性休克和非休克患者外周血EPC变化的特点.方法 收集2007年8月至2008年2月复大学附属中山医院急诊科收治的脓毒症患者27例进行前瞻性研究,其中感染性休克患者12例、非休克患者15例,另选10例健康成年人作为正常对照,ICU非脓毒症患者10例作为ICU对照.Ficoll梯度离心法分离外周血PBMC,通过流式细胞仪检测外周血PBMC标记的CDl33,CIY34和血管内皮牛长因子受体-2(vascular endothelialgrowth factor receptor-2.VEGFR-2)的表达情况,计算祖细胞以及内皮祖细胞的相对数量.组间比较采用单因素方差分析.结果 健康成年人外周血祖细胞、EPC数量较少,分别占PBMC的0.25%.4-0.14%和0.09%.4-0.02%;ICU非脓毒症患者祖细胞和EPC数量分别占PBMC的0.38%.4-0.29%和0.12%.4-O.02%,与正常对照组相比无明显的变化(P>0.05);脓毒症非休克组患者外周血祖细胞、EPC的数量明显增加,分别占PBMC的0.57%±0.12%和0.22%±0.10%,与正常对照组相比差异具有统计学意义(P<0.05);感染性休克患者外周血祖细胞和EPE的数量明显减少,分别占PBMC的0.20%.4-0.12%和0.04%±O.01%,与非休克组、ICU对照组和正常对照组相比差异均具有统计学意义(P相似文献   

内皮祖细胞与缺血性脑卒中

背景:内皮祖细胞不仅能够早期预测血管损伤的程度,而且具有修复损伤的内皮细胞、促进新生血管形成管腔结构、参与神经再生的功能.内皮细胞移植已逐渐应用于血管相关性疾病的治疗.目的:文章综述了内皮祖细胞的生物学特性及在缺血件脑卒中领域的最新研究进展,为其临床应用提供理论支持.方法:以"endothelial progenitor cells: ischemic infarction:"为检索词检索Medline、HighWire Press数据库f2000 01/2009-12).纳入与血管新生,内皮和神经再生密切相关的研究,排除内容陈旧、重复性及缺乏可信度文章.结果与结论:计算机仞检得到126篇文献,根据纳入排除标准,对其中28篇文献进行分析.内皮祖细胞具有修复损伤的内皮细胞、延缓动脉粥样硬化进展、促进缺血组织新生血管形成等功能,它参与缺血件脑卒中后血管新生,防治支架术后血栓形成及再狭窄,预测脑缺血的发生及预后,在防治缺血性脑卒中方面具有广泛的应崩前景.     

维持性血液透析患者循环内皮祖细胞变化的临床分析

目的 观察维持性血液透析患者循环内皮祖细胞(circulating endothelial progenitor cells,CEPCs)的变化.方法 以外周血中CD34+/CD133+/KDR + 为循环内皮祖细胞的标志物,对44例维持性血液透析患者和36例健康体检者采用流式细胞仪检测 CEPCs数量;将维持性血液透析患者的CEPCs数量与对照组比较,并根据维持性血液透析患者有无高血压或冠心病史、透析是否充分、血红蛋白水平进一步作亚组分析.结果维持性血液透析患者外周血CEPCs数量显著低于对照组( tCD34+=2.205,tCD34+/CD133+/KDR+ =2.148;均P＜0.05);合并高血压的维持性血液透析患者CEPCs数量较无高血压者显著降低(tCD34+ =2.183,tCD34+/CD133+/KDR+=2.023;均 P＜0.05);有冠心病史的维持性血液透析患者CEPCs数量低于无冠心病史者 (tCD34+=2.136,tCD34+/CD133+/KDR+ = 2.072;均P＜0.05);Kt/V≥1.3组患者CEPCs 数量明显高于Kt/V＜1.3组(tCD34+ =2.276,tCD34+/CD133+/KDR+=2.086;均 P＜0.05);血红蛋白≥110g/L组患者较血红蛋白＜110g/L组患者 CEPCs数量为高(tCD34+=2.707,t CD34+/CD133+/KDR+=2.859;均P＜0.05).结论 充分血液透析、积极控制高血压、改善肾性贫血使血红蛋白达标有助于提高维持性血液透析患者循环内皮祖细胞数量,有助于降低发生心血管并发症的风险.     

系统性硬皮病患者外周血内皮祖细胞数量及分化功能的研究

目的探讨系统性硬皮病（Systemic scleroderma,SSc）患者外周血内皮祖细胞（endothelial progenitor cells,EPCs）数量和分化功能的变化。方法选取女性SSc患者及健康志愿者各20例,抽取外周血20 ml,密度梯度离心法分离单个核细胞,以CD133/CD34、CD133/VEGFR2双荧光标记鉴定细胞,CD34/CD133/VEGFR2三荧光标记流式检测EPCs数量;分别以PE标记抗人CD14,FITC标记抗人CD64,PerCP/Cy5.5标记抗人VEGFR2,流式细胞仪检测单阳性细胞率,进而比较分化功能。结果 SSc患者外周血EPCs表达阳性率（3.18±1.97）%,较健康对照的（20.56±4.37）%明显下降,差异有统计学意义（P〈0.01）;培养7天后,外周血单个核细胞表达单核细胞表面标志CD14＋、CD64＋细胞百分率（32.49±5.41）%、（30.57±4.83）%,与对照组的（14.76±2.37）%、（15.39±2.09）%比较明显增加,差异均有统计学意义（均P〈0.01）,而内皮细胞表面标记KDR＋细胞百分率（68.38±4.65）%与对照组的（89.81±5.13）%比较明显减低,差异有统计学意义（P〈0.01）。结论 SSc患者循环内皮祖细胞数量减少,分化功能降低。     

Plasma homocysteine level and functional outcome of patients with ischemic stroke

OBJECTIVE: To investigate the possible relationships between total plasma homocysteine level (tHcy) and functional outcome of stroke patients as evaluated by the FIM instrument. DESIGN: Retrospective chart analysis. SETTING: Inpatient stroke rehabilitation ward of a university-affiliated referral hospital. PARTICIPANTS: Consecutive patients (N=113) presenting with acute ischemic stroke. Patients were divided into 2 groups according to their tHcy levels (< or = 15 micromol/L, >15 micromol/L) and into 3 groups according to their FIM scores (low, < or =40; moderate, 41-80; high, >80). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The tHcy level was determined shortly after stroke onset by a high performance liquid chromatography method with fluorescence detection. Functional outcome was measured by the FIM instrument at admission and discharge. The tHcy level and FIM scores were obtained for all patients. Data outcomes were analyzed by t tests, 1-way analysis of variance, Mann-Whitney U, and Fisher exact tests, as well as by the 2 ordered polytomous logistic regression model. RESULTS: The 2 tHcy groups were similar in demographic, stroke, and comorbidity characteristics, differing only by higher frequency of hypertension in those with a tHcy greater than 15 micromol/L (51.7% vs 80.8%, respectively, P=.01). Compared with patients who had tHcy levels at 15 micromol/L or lower and were discharged from rehabilitation being in the highest FIM score group (>80), higher tHcy levels were not associated with a discharge FIM score of less than 40 (odds ratio [OR]=.77; 95% confidence interval [CI], 0.13-4.65; P=.77) or with a better functional outcome FIM score between 40 and 80 (OR=3.71; 95% CI, 0.73-18.99; P=.11). CONCLUSIONS: Our findings suggest that determination of tHcy level does not correlate with functional outcome in patients presenting for rehabilitation after acute ischemic stroke.     

2型糖尿病合并急性冠脉综合征患者循环内皮祖细胞变化的研究

目的 观察2型糖尿病合并急性冠脉综合征(ACS)患者循环内皮祖细胞(EPCs)数量及功能的变化,探究EPCs参与糖尿病大血管病变发生的机制.方法 2型糖尿病患者42例、2型糖尿病合并ACS患者45例和健康志愿者40例.用密度梯度离心法分离单个核细胞,流式细胞仪检测循环EPCs数量；体外培养观察EPCs迁移能力.结果 与正常对照组比较,2型糖尿病患者和2型糖尿病合并ACS患者EPCs数量明显减少(P＜0.01)；2型糖尿病合并ACS患者较单纯2型糖尿病患者的EPCs数量减少(P＜0.01).2型糖尿病合并ACS及2型糖尿病患者循环EPCs迁移能力较正常对照组明显下降(P＜0.01),2型糖尿病合并ACS患者较单纯2型糖尿病患者EPCs迁移能力也有下降(P＜0.05).结论 2型糖尿病合并ACS患者循环EPCs数量减少、功能受损,可能参与2型糖尿病大血管并发症的发生和发展.     

Effects of immunoadsorption on endothelial function,circulating endothelial progenitor cells and circulating microparticles in patients with inflammatory dilated cardiomyopathy

Background  

Immunoadsorption (IA) is used in patients with chronic inflammatory dilative cardiomyopathy (iDCM) to remove cardiotoxic autoantibodies, and to improve myocardial function. We examined the effects of IA on endothelial function, circulating endothelial progenitor cells, and circulating microparticles, including endothelial-derived microparticles, in patients with chronic iDCM.     

Detection of circulating endothelial cells and endothelial progenitor cells by flow cytometry

The finding of angiogenic and vasculogenic cells in the peripheral circulation may have profound effects on the course of a variety of diseases ranging from cancer to cardiovascular disease. These cells are ascribed to be endothelial in nature and are generally referred to as circulating endothelial cells if mature or as endothelial progenitor cells if immature. Different approaches have been used to detect these cells, including in vitro culture, magnetic bead isolation, and flow cytometry. We review flow cytometric methods for the detection and enumeration of these cells and provide technical suggestions to promote the accurate enumeration of circulating endothelial cells and endothelial progenitor cells.     

冠状动脉慢血流患者外周血内皮祖细胞数量的变化

目的:观察冠状动脉慢血流患者外周血内皮祖细胞(EPCs)数量的变化.方法:选择26例冠状动脉造影证实为慢血流的患者为CSF组,冠脉造影血流正常的患者20例为NCF组.以校正TIMI帧数＞27诊断为冠状动脉慢血流.分别抽取外周血进行EPCs的分离培养,于第10天对EPCs进行鉴定,并于倒置像差显微镜下计数EPCs克隆形成单位,评估两组患者外周血EPCs水平的差异.结果:(1)两组在年龄、性别、吸烟史、高血压、糖尿病、冠心病家族史、血脂方面均无明显统计学差异(P＞0.05);(2)CSF组外周血EPCs水平较NCF组明显下降(11.2±2.9 vs.17.1±2.4),差异有统计学意义(P＜0.01).结论:冠状动脉慢血流患者外周血EPCs数量减少.     

Impaired colony-forming capacity of circulating endothelial progenitor cells in patients with emphysema

Chronic obstructive pulmonary disease (COPD) is classified into emphysema and chronic bronchitis, which are thought to result from different pathophysiological pathways. Smoking-induced lung parenchymal destruction and inadequate repair are involved in the pathogenesis of emphysema. In addition, decreased expression of vascular endothelial growth factor and increased endothelial cell apoptosis in the lung may participate in emphysema pathogenesis. As stem cells, circulating endothelial progenitor cells (EPCs) may play a key role in the maintenance of vascular integrity by replacing and repairing the damaged endothelial cells in the tissues. To determine whether the lack of appropriate repair by circulating EPCs in cases of smoking-induced endothelial cell injury participates in emphysema pathogenesis, we determined the association between the colony-forming or migratory capacity of circulating EPCs and the presence of emphysema in 51 patients with COPD. The patients were divided into emphysema (n = 23) and non-emphysema groups (n = 28) based on high-resolution computed tomography. Twenty-two smokers with normal lung function and 14 normal non-smokers served as controls. Circulating EPCs isolated from patients with emphysema showed significantly lower colony-forming units (CFUs) than those from patients with non-emphysema group, smokers with normal lung function, and normal non-smokers. EPCs from patients with emphysema showed significantly lower migratory capacity than those from normal non-smoking controls (p < 0.05). On multivariate analysis, the EPC-CFU was independently associated with emphysema (OR 0.944, 95% CI = 0.903-0.987, p = 0.011). Thus, impaired functions of circulating EPCs may contribute to the development of emphysema.     

运动条件下健康人循环内皮祖细胞的数量和功能

背景：运动条件对内皮祖细胞数量和功能是否会产生的影响目前尚无公识。目的：观察急性运动对健康成人循环内皮祖细胞数量和功能的影响。方法：健康男性成人志愿者12例参加急性平板运动锻炼（9.3±2.1）min。用流式细胞仪测定运动前后CD34和KDR双标阳性循环内皮祖细胞水平,ac-LDL及lectin荧光标记方法评估体外培养内皮祖细数量,检测内皮祖细胞的黏附、迁移和增殖能力,并测定运动前后血浆和内皮祖细胞分泌一氧化氮、血管内皮生长因子和粒-巨噬细胞集落刺激因子水平变化。结果与结论：流式细胞仪检测显示健康志愿者运动后循环内皮祖细胞水平较运动前增加（P〈0.05）。荧光标记法证实运动后ac-LDL及lectin抗体双阳性内皮祖细胞数量较运动前增加（P〈0.05）,内皮祖细胞迁移和增殖能力明显增强（P〈0.05）,但黏附能力无明显变化。急性运动能明显增加健康志愿者的血浆一氧化氮水平（P〈0.05）,健康志愿者运动前后血浆一氧化氮水平和循环内皮祖细胞数量及功能的增加倍数呈明显的直线相关回归关系（P〈0.05）。结果证实,运动可明显增加健康成人循环内皮祖细胞的数量和功能,其机制与其诱导一氧化氮释放增多有关。     

Increased circulating endothelial progenitor cells in septic patients: correlation with survival

OBJECTIVE: Endothelial damage and detachment of endothelial cells are known to occur in septic patients. Thus, recruitment of circulating endothelial progenitor cells (cEPCs) to these lesions might have a beneficial effect on the clinical course in septic patients. Therefore, we were interested in whether EPCs, detected by flow cytometry, are increasingly mobilized during sepsis and if this mobilization is associated with clinical outcome. DESIGN: Prospective, nonrandomized study. SETTING: Intensive care unit of a university hospital. PATIENTS: Patients with (n = 32) and without (n = 15) sepsis and healthy volunteers (n = 15). INTERVENTIONS: Peripheral blood mononuclear cells were isolated by Ficoll density gradient centrifugation, and cEPCs were characterized by three-color fluorescence flow cytometry using antibodies against CD133, CD34, and vascular endothelial growth factor receptor-2. Serum concentrations of vascular endothelial growth factor, granulocyte macrophage-colony stimulating factor, and erythropoietin were determined by enzyme-linked immunosorbent assay. Severity of sepsis was assessed according to Acute Physiology and Chronic Health Evaluation II scoring. MEASUREMENTS AND MAIN RESULTS: In septic patients, the number of cEPCs was significantly higher than in nonseptic intensive care unit patients (p < .05) and healthy controls (p < .02). Nonsurvivors (n = 8), defined as death within 28 days after onset of sepsis, had significantly lower numbers of cEPCs than survivors (n = 24) (p < .0001). The number of cEPCs was correlated with survival in septic patients. Serum vascular endothelial growth factor concentrations were significantly higher in septic patients compared with nonseptic intensive care unit patients and healthy controls (p < .01) and correlated with the cEPC numbers (p < .0001). Similar findings were observed for granulocyte macrophage-colony stimulating factor and erythropoietin. CONCLUSIONS: Our data suggest that cEPC enumeration in peripheral blood of septic patients might be a valuable marker to assess the clinical outcome in these patients.     

Plasma Klotho concentrations predict functional outcome at three months after acute ischemic stroke patients

Background: The Klotho protects the cardiovascular system by protecting against cell apoptosis, inhibiting the production of reactive oxygen species, and modulating inflammation. We aimed to investigate relationship of plasma Klotho concentrations with functional outcome at 3 months after acute cerebral infarction.

Methods: We prospectively enrolled 262 first-ever acute cerebral infarction patients from whom a blood sample was acquired within 24?h of admission. An enzyme-linked immunosorbent assay was used for evaluating plasma Klotho concentration. Functional outcome on admission and three months was evaluated.

Results: Of the 262 patients, 152 (58.0%) were men. The mean age of these patients was 64.7 years. The mean?±?standard deviation of plasma Klotho concentrations was 312.7?±?153.3?pg/mL. As opposed to patients with good outcome, plasma Klotho levels were lower in the poor outcome group (207.8?±?96.2 vs. 342.5?±?153.5?pg/mL, p?=?.001). In multivariate analysis, increased plasma Klotho concentrations were independently associated with good functional outcome (Odds ratio: 2.42, 95% confidence interval: 1.45–4.04, p?<?.001).

Conclusions: Increased plasma Klotho concentrations were associated with good functional outcome in patients with acute ischemic stroke. We attribute these associations to the pleiotropic effects of Klotho in stroke and vascular diseases.

• Key message

• Increased plasma Klotho concentrations were associated with good functional outcome in patients with acute ischemic stroke.

     

促红细胞生成素对大鼠内皮祖细胞生物学特点的影响

背景:内皮祖细胞是内皮细胞的前体细胞,可参与新生血管的形成.研究发现,促红细胞生成素对骨髓内皮祖细胞有动员作用,促进血管的新生和损伤组织修复.目的:观察不同浓度促红细胞生成素对体外培养的大鼠内皮祖细胞功能的影响.方法:提取Wistar大鼠股骨和胫骨骨髓,利用密度梯度离心方法分离单核细胞进行培养,分别在培养基中加入0,4,8 U/mL不同浓度的促红细胞生成索进行培养.培养7 d后,对内皮祖细胞利用FITC-UEA-1和Dil-Ac-LDL共同染色方法进行鉴定;同时利用CD34和CD133共同标记,以流式细胞仪进行鉴定;采用黏附实验、迁移实验及MTT实验对其功能进行评定.结果与结论:培养到7d左右,细胞形态变化完全,细胞之间形成联接,并可以围成似管腔状形态,十二三天时,细胞融合,形成铺路石样.培养细胞荧光染色显示内皮祖细胞里双阳性染色,经流式细胞仪鉴定培养的内皮祖细胞可以结合CD133和CD34.黏附实验、迁移实验及MTT实验显示,促红细胞生成素呈剂量依赖性提高内皮祖细胞的黏附、迁移和增殖能力.说明在0-8 U/mL浓度内,促红细胞生成素呈剂量依赖性提高内皮祖细胞的黏附、迁移和增殖功能.     

Acute and chronic effects of exercise on circulating endothelial progenitor cells in healthy and diseased patients

Exercise is known to improve endothelial function in healthy subjects as well as patients with cardiovascular disease and this might be partially related to a regeneration of diseased endothelium by circulating progenitor cells (EPCs). EPCs are a subgroup of peripheral blood monocytes that contribute to re-endothelialization of injured endothelium as well as neovascularization of ischemic lesions. Cross-sectional studies have indicated that chronic, regular physical activity has a positive effect on the levels of circulating EPCs. This is associated with an improvement of endothelial dysfunction that is induced by apoptosis due to the underlying aging process or accelerated by cardiovascular risk factors. Furthermore, it is well established that chronic exercise training has the potency to mobilize EPCs from the bone marrow. For patients with cardiac disease this is of clinical importance since EPCs have been implicated in vascular repair and revascularization. Studies are needed to refine the best mode of exercise training that will upregulate circulating EPCs as well as to clarify the kinetics of EPCs after the termination of different exercise sessions in different diseases and medication. Whether there is a direct link between enhanced mobilization of EPCs via exercise and improvement of disease and prognosis remains a hypothesis which needs to be further evaluated.     

冠状动脉支架置入后再狭窄患者外周血内皮祖细胞数量及活性的变化

背景：近年来发现的内皮祖细胞能够促进受损内皮愈合,因而假设支架置入后再狭窄可能与内皮祖细胞的数量和/或活性有关。目的：对比观察冠状动脉支架置入后再狭窄患者与未发生再狭窄患者循环内皮祖细胞数量及活性,验证上述假设。设计、时间及地点：对比观察实验,于2005-03/2007-05在北京世纪坛医院心内科、北京大学第一医院心内科及北京大学医学部生理学与病理生理学系完成。对象：根据复查冠脉造影的结果将来源于北京大学第一医院、既往行冠脉支架置入的患者分为两组：发生支架置入后再狭窄组（n=15）及未发生支架置入后再狭窄的对照组（n=17）。方法：采用密度梯度离心法获取外周血总的单个核细胞,接种到包被有人纤维连接蛋白的24孔培养板,7d后通过激光共聚焦显微镜测定贴壁细胞摄取DiI-acLDL及结合FITC-UEA-Ⅰ的能力,双染色阳性的细胞为正在分化的内皮祖细胞。主要观察指标：外周血单个核细胞培养7d后,通过倒置显微镜计算内皮祖细胞的数量、通过MTT比色法测定内皮祖细胞增殖倍数、通过划痕试验定性观察内皮祖细胞的迁移数量以及通过黏附试验测定内皮祖细胞的黏附率。结果：再狭窄组内皮祖细胞数量明显低于对照组（P=0.001）,再狭窄组的内皮祖细胞增殖倍数明显低于对照组（P〈0.05）,再狭窄组的内皮祖细胞迁移数量明显低于对照组,但两组之间的内皮祖细胞黏附率差异无显著性意义（P〉0.05）。结论：冠状动脉支架置入后再狭窄患者的内皮祖细胞数量及增殖能力、迁移能力明显下降,说明支架置入后再狭窄可能与内皮祖细胞的数量和/或活性有关。     

无创性超声测定冠状动脉支架术后再狭窄患者血管内皮功能和循环内皮祖细胞水平

目的运用无创性超声诊断技术测定经皮冠状动脉介入术（PCI）治疗急性心肌梗死（AMI）愈后冠状动脉支架再狭窄（ISR）患者的血管内皮功能,并探讨血管内皮功能与循环内皮祖细胞（EPCs）水平变化特点。 方法选取2009—2015年川北医学院附属医院收治的完成冠状动脉造影随访的急性心肌梗死（AMI）后行PCI治疗患者220例。29例患者PCI治疗AMI后发生ISR（ISR组）,191例患者PCI治疗AMI后未发生ISR（非ISR组）。采用高频超声技术获取患者肱动脉内皮依赖性功能（FMD）、非内皮依赖性功能（NMD）和颈动脉内膜中层厚度（IMT）,同时检测循环EPCs表达水平。用独立样本t检验比较ISR组与非ISR组患者IMT、FMD、NMD、CD133＋/KDR＋EPCs、CD34＋/KDR＋EPCs、CD34＋EPCs、CD133＋EPCs、KDR＋EPCs水平差异;采用单因素及多因素非条件Logistic回归分析筛选冠状动脉ISR的独立预测因子。 结果ISR组患者糖化血红蛋白（HbA1c）、尿素氮、肌酐浓度均高于非ISR组患者,且差异均有统计学意义（t值分别为-1.769、-3.671、2.77,P均<0.05）,血管紧张素转化酶抑制剂/血管紧张素受体拮抗剂、周围血管扩张剂、胰岛素、利尿剂使用率均高于非ISR组患者,硝酸甘油使用率低于非ISR组患者,且差异均有统计学意义（χ²值分别为3.832、6.567、2.072、16.540、4.949,P均<0.05）。2组患者IMT、FMD差异均无统计学意义,但ISR组患者NMD低于非ISR组患者,且差异有统计学意义（t=2.338,P均<0.05）。2组患者CD34＋EPCs、CD133＋EPCs水平差异均无统计学意义;ISR组患者CD34/KDR＋EPCs、CD133/KDR＋EPCs、KDR＋EPCs水平均较非ISR组患者降低,且差异均有统计学意义（t值分别为2.298、3.986、2.106,P均<0.05）。Logistic回归分析结果显示,HbA1c浓度、硝酸甘油使用率、利尿剂使用率、NMD是ISR的独立预测因子。 结论阶段性血糖水平等危险因素控制不良,损害血管壁功能,减少循环EPCs数量,结合老年冠状动脉粥样硬化性心脏病患者置入支架的特定人群和临床用药合理性等因素综合作用下,促进PCI后ISR发生。高频超声技术可以快速、无创测定血管内皮功能,间接反映冠状动脉受损情况,在PCI后ISR发生的风险因素评估中准确评价血管结构和功能变化,为临床治疗提供重要的诊断和治疗依据。     

Serum level and prognostic value of neopterin in patients after ischemic stroke

Background

We hypothesized that serum level of neopterin is significantly predictive of prognostic outcome in patients after acute ischemic stroke (IS).

Methods

Between November 2008 and May 2010, serum levels of neopterin were prospectively collected at 48 h after acute IS in 157 patients.

Results

Serum neopterin levels were substantially higher in patients with severe neurological impairment [National institutes of Health Stroke Scale (NIHSS) score ≥ 12] than in those with NIHSS < 12 (p < 0.008). Furthermore, Spearman's test showed a strongly positive correlation between neopterin level and NIHSS (p = 0.003). Multiple logistic regression analysis demonstrated that serum neopterin level was strongly and independently predictive of NIHSS ≥ 12 (p = 0.002) at 48 h after acute IS and 90-day major adverse clinical outcome (defined as NIHSS ≥ 12, recurrent stroke or death) (p = 0.003).

Conclusion

Serum level of neopterin was notably increased after acute IS. This biomarker was strongly and independently predictive of 90-day unfavorable clinical outcome in patients after acute IS.