Analysis of the association of MPO and MMP-9 with stroke severity and outcome

医学 髓过氧化物酶 冲程(发动机) 内科学 脑出血 改良兰金量表 组织纤溶酶原激活剂 格拉斯哥结局量表 脑缺血 胃肠病学 缺血 缺血性中风 麻醉 炎症 格拉斯哥昏迷指数 蛛网膜下腔出血 工程类 机械工程
作者
Ilaria Maestrini,Madjid Tagzirt,Sophie Gautier,Annabelle Dupont,Anne‐Marie Mendyk,Sophie Susen,Anne Tailleux,Emmanuelle Vallez,Bart Staels,Charlotte Cordonnier,Didier Leys,Régis Bordet
出处
期刊:Neurology [Lippincott Williams & Wilkins]
卷期号:95 (1) 被引量:45
标识
DOI:10.1212/wnl.0000000000009179
摘要

In acute cerebral ischemia, circulating neutrophil count and neutrophil-to-lymphocyte ratio (NLR) are positively associated with stroke severity and worse outcomes. Mediators of this effect are unknown. We aimed to investigate (1) the relationship between plasma matrix metalloproteinase-9 (MMP-9) and myeloperoxidase (MPO) concentrations with stroke severity and outcome and (2) MMP-9 and MPO release after ex vivo stimulation of neutrophils by recombinant tissue plasminogen activator (rtPA).We analyzed data collected in 255 patients with supratentorial cerebral infarcts recruited within 48 hours of symptoms onset irrespective of rtPA treatment. The endpoints were excellent outcome (modified Rankin Scale score 0-1), symptomatic intracerebral hemorrhage (European Cooperative Acute Stroke Study-II definition), and death at 3 months. The role of rtPA treatment on peripheral neutrophil degranulation was investigated in 18 patients within 4.5 hours and after 72 hours.Neutrophil counts, NLR, and MPO plasma concentrations, but not MMP-9, were positively correlated with stroke severity. Higher neutrophil counts and NLR were independently associated with worse outcomes and higher mortality rates at month 3. Higher MPO plasma concentrations, but not MMP-9, were associated with worse outcome. Neutrophil-derived MMP-9, after ex vivo rtPA stimulation, but not MPO, were higher after 72 hours in patients treated by IV rtPA but not associated with hemorrhagic transformation.Neutrophil counts, NLR, and MPO plasma concentrations are associated with worse outcome in patients with acute cerebral ischemia, in contrast to MMP-9. Further investigations are needed to deepen our knowledge on MPO's role in the deleterious effect of neutrophils because it could represent a potential therapeutic target.
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