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Abstract
Background Performing endovascular treatment (EVT) in patients with acute ischemic stroke (AIS) allows a port of entry for intracranial biological sampling.
Objective To test the hypothesis that specific immune players are molecular contributors to disease, outcome biomarkers, and potential targets for modifying AIS.
Methods We examined 75 subjects presenting with large vessel occlusion of the anterior circulation and undergoing EVT. Intracranial blood samples were obtained by microcatheter aspiration, as positioned for stent deployment. Peripheral blood samples were collected from the femoral artery. Plasma samples were quality controlled by electrophoresis and analyzed using a Mesoscale multiplex for targeted inflammatory and vascular factors.
Results We measured 37 protein biomarkers in our sample cohort. Through multivariate analysis, adjusted for age, intravenous thrombolysis, pretreatment National Institutes of Health Stroke Scale and Alberta Stroke Program Early CT scores, we found that post-clot blood levels of interleukin-6 (IL-6) were significantly correlated (adjusted P value <0.05) with disability assessed by the modified Rankin Scale (mRS) score at 90 days, with medium effect size. Chemokine (C-C) ligand 17 CCL17/TARC levels were inversely correlated with the mRS score. Examination of peripheral blood showed that these correlations did not reach statistical significance after correction. Intracranial biomarker IL-6 level was specifically associated with a lower likelihood of favorable outcome, defined as a mRS score of 0–2.
Conclusions Our findings show a signature of blood inflammatory factors at the cerebrovascular occlusion site. The correlations between these acute-stage biomarkers and mRS score outcome support an avenue for add-on and localized immune modulatory strategies in AIS.
- Thrombectomy
- Inflammation
- Stroke
- Angiography
- Brain
Data availability statement
Data are available upon reasonable request.
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Data availability statement
Data are available upon reasonable request.
Footnotes
CD, VC and NM contributed equally.
Contributors Substantial contributions to the conception or design of the work: CD, MB, NM, JL, VC. Acquisition, analysis, or interpretation of data for the work: all authors. Drafting the work or revising it critically for important intellectual content: CD, NM, JL. Final approval of the version to be published: all authors. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: all authors. CD, VC, PMac and NM: conception and design of the study, analysis of data, and drafting of the manuscript. MB, FdB, CH, PM: technical analyses of samples. MM: acquisition of patients’ characteristics, registry. CD, VC, MM: patients’ recruitment and approval. CD, VC, ID, RAR, GG, PHL, FR, JF, CA, FC,AtS, RB: samples obtainment and circuit. All authors contributed to the article and approved the submitted version. FC in samples obtainment and circuit. CD is acting as the guarantor.
Funding This study was funded by Stryker Neurovascular.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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