Relationship between cytokine concentration and activities of daily living in rehabilitation patients with stroke

Stroke rehabilitation is effective in some patients, however not so effective in others. Our ultimate aim is to use the clinical laboratory assessment as a tool for effectiveness discrimination in rehabilitation. Subjects were 15 stroke patients (68.1 +/- 12.7 years old) who were admitted to our convalescent rehabilitation wards. Fasting blood samples were analyzed for serum concentrations of hepatocyte growth factor (HGF), vascular endothelial growth factor (VEGF) and insulin-like growth factor-I (IGF-I) which are considered to be involved in hypermyotrophy using ELISA methods on admission and at discharge. Sixteen healthy control subjects (63.0 +/- 7.6 years old) were also employed. As accuracy control of these analyses, decrease of serum HGF after keeping at -20 degrees C for 499 days were measured. The concentration was 0.66ng/mL from 0.71 ng/mL and residual ratio was 94.0%. Reaction specificity to MW 60 kDa HGF antibody using the Western blot method was confirmed. Average HGF and VEGF were higher in stroke patients than those in control subjects. Average IGF-I was lower in stroke patients. The correlations between HGF, VEGF, and IGF-I and the score of activities of daily living expressed by the Functional Independence Measure (FIM) were calculated. Highest correlation coefficient of 0.67 (p < 0.01) was obtained between HGF at discharge and the FIM efficiency (the gain of the FIM during hospitalization divided by length of stay). The correlation coefficients related to VEGF or IGF showed lower value. High FIM efficiency denotes rapid recovery with vigorous exercise. HGF at discharge would reflect the result of high activity.