Post-Stroke Infection: A Role for IL-1ra?
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Pat Tanzi • Kevin Cain • Angela Kalil • Dannielle Zierath • Anna Savos • J. Michael Gee • Dean Shibata • Jessica Hadwin • Kelly Carter • Kyra Becker
- چاپ و سال / کشور: 2011
Description
Background Infection is common following stroke and is independently associated with worse outcome. Clinical studies suggest that infections occur more frequently in those individuals with stroke-induced immunologic dysfunction. This study sought to explore the contribution of immunomodulatory cytokines and hormones to lymphocyte function and infection risk. Methods Patients (N = 112) were enrolled as soon as possible after the onset of ischemic stroke. Blood was drawn to assess plasma cortisol, IL-10, IL-1ra, lymphocyte numbers, and lymphocyte function at 72 h after stroke onset; infections were censored through 21 days after stroke onset. Results Infection occurred in 25% of patients. Stroke severity was the most important predictor of infection risk. Increased plasma cortisol, IL-10, and IL-1ra, as well as decreased lymphocyte numbers, at 72 h after stroke onset were associated with risk of subsequent infection. After controlling for stroke severity, only IL-1ra was independently associated with infection risk, and the degree of risk was consistent throughout the post-stroke period. Infection, but not IL-1ra itself, was associated with worse outcome at 3 months. Conclusions In this study cohort, increased plasma IL-1ra was independently associated with the risk of post-stroke infection. Further studies are needed to validate this finding, which could have important implications for stroke therapy.
Neurocrit Care (2011) 14:244–252 DOI 10.1007/s12028-010-9490-7 Published online: 21 December 2010
