Post-Stroke Infection: A Role for IL-1ra?
| Autor: | Angela Kalil, Pat Tanzi, Anna V. Savos, Kevin C. Cain, J. Michael Gee, Jessica Hadwin, Kelly T. Carter, Dean Shibata, Dannielle Zierath, Kyra J. Becker |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Male medicine.medical_specialty Neurology Critical Care Hydrocortisone Lymphocyte Infections Critical Care and Intensive Care Medicine Severity of Illness Index Article Cohort Studies Risk Factors Internal medicine Severity of illness Humans Medicine cardiovascular diseases Stroke Aged business.industry Middle Aged medicine.disease Interleukin 1 Receptor Antagonist Protein Interleukin 10 medicine.anatomical_structure Acute Disease Cohort Immunology Female Neurology (clinical) business Hormone Cohort study |
| Zdroj: | Neurocritical Care. 14:244-252 |
| ISSN: | 1556-0961 1541-6933 |
| Popis: | 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. 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. 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. 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. |
| Databáze: | OpenAIRE |
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