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Clinical value of serum JKAP in acute ischemic stroke patients
Authors:Jianli Zhang  Jing Yang  Jingchun Hu  Weiwei Zhao
Abstract:BackgroundJun N‐terminal kinase pathway‐associated phosphatase (JKAP) regulates neuronal function, T helper (Th) 1/2/17 cell differentiation, and inflammatory process, but its clinical role in acute ischemic stroke (AIS) patients remains unclear. Hence, this study intended to evaluate JKAP level and its relationship with disease severity, Th1, 2, 17 secreted cytokines, adhesion molecules, and prognosis of AIS patients.MethodsSerum JKAP of 122 AIS patients and 50 controls was detected by ELISA. For AIS patients only, Th1, 2, 17 secreted cytokines IFN‐γ, IL‐4, IL‐17; TNF‐α, ICAM‐1, and VCAM‐1 were also detected by ELISA.ResultsJKAP was decreased in AIS patients compared with controls (46.350 (interquartile range (IQR): 34.250–59.875) pg/ml vs. 84.500 (IQR: 63.175–113.275) pg/ml, p < 0.001), which could distinguish AIS patients from controls (area under curve (AUC): 0.810, 95% confidence interval (CI): 0.732–0.888). In AIS patients, JKAP negatively linked with the National Institutes of Health Stroke Scale (NIHSS) score (rs  = −0.342, p < 0.001); besides, it was positively related to IL‐4 (rs  = 0.213, p = 0.018) and negatively associated with IL‐17 (rs  = −0.270, p = 0.003) but not related to IFN‐γ (rs  = −0.146, p = 0.109). Furthermore, elevated JKAP associated with declined TNF‐α (rs  = −0.219, p = 0.015) and ICAM‐1 (rs  = −0.235, p = 0.009) but not related to VCAM‐1 (rs  = −0.156, p = 0.085). Besides, declined JKAP was linked with 2‐year recurrence (p = 0.027) and 3‐year recurrence (p = 0.010) in AIS patients; while JKAP was not related to 1‐year recurrence or death risk (both p > 0.050).ConclusionJKAP may sever as a candidate prognostic biomarker in AIS patients, indicating its potency for AIS management.
Keywords:acute ischemic stroke, disease severity, inflammation cytokines, Jun N‐  terminal kinase pathway‐  associated phosphatase, prognosis
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