Evaluation of plasma levels of neopterin and soluble CD40 ligand in patients with acute ischemic stroke in upper Egypt: can they surrogate the severity and functional outcome?
Received 20 June 2018
Accepted for publication 3 December 2018
Published 22 February 2019 Volume 2019:15 Pages 575—586
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Roger Pinder
Abeer A Tony,1 Effat AE Tony,2 Wafaa Salah Mohammed,3 Emad F Kholef3
1Department of Neuropsychiatry, Faculty of Medicine, Aswan University, Aswan, Egypt; 2Department of Internal Medicine, Nephrology Unit, Faculty of Medicine, Assuit University, Assuit, Egypt; 3Department of Clinical Pathology, Faculty of Medicine, Aswan University, Aswan, Egypt
Background: Inflammation constitutes a major component of ischemic stroke pathology. The prognostic value of “neopterin” and soluble CD40 ligand (sCD40L), as a potential biomarker of ischemic stroke, has been less extensively studied.
Objectives of the study: This study aims at assessing the serum levels of neopterin and sCD40L in acute ischemic stroke (AIS), to clarify its association with the severity, etiology, and risk factors of stroke, and to evaluate their relationship with the stroke functional outcome in our study sample within 90 days of follow-up.
Study sample: This case–control study was conducted on 100 patients with first-ever acute onset ischemic stroke and 25 control subjects.
Methods: Participants were subjected to full history taking and detailed clinical and neurological examination. Brain imaging was performed after hospital admission. Blood tests were drawn for assessment of neopterin and sCD40L on the first day of admission.
Results: High levels of neopterin and sCD40L was reported. Their levels were significantly higher in relation with survival status. There was a relationship between AIS and sCD40L levels and the severity of the stroke. Within 3 months of follow-up, these biomarkers were associated significantly with poor functional outcome, within a 90-day follow-up period, and mortality. These biomarkers were highly associated in patients with small vessel occlusion as an etiology for AIS.
Conclusion: Neopterin and sCD40L levels increased after AIS. Both biomarkers were strong and independent predictors of 90-day unfavorable clinical outcome and death in patients after AIS.
Keywords: acute ischemic stroke, soluble CD40 ligand, neopterin, stroke risk factors, functional outcome
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