Inflammatory markers in pediatric stroke: An attempt to better understanding the pathophysiology

Bürki, Sarah Elisabeth; Grandgirard, Denis; Datta, Alexandre N; Hackenberg, Annette; Martin, Florence; Schmitt-Mechelke, Thomas; Leib, Stephen L; Steinlin, Maja (2016). Inflammatory markers in pediatric stroke: An attempt to better understanding the pathophysiology. European journal of paediatric neurology, 20(2), pp. 252-260. Elsevier 10.1016/j.ejpn.2015.12.006

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BACKGROUND The mechanisms of childhood and perinatal arterial ischemic stroke (AIS) are poorly understood. Multiple risk factors include cerebral arteriopathy, congenital cardiac disease, infection, sickle cell disease, and maternal-fetal conditions in neonates. For infections and parainfectious conditions being the most important a possible inflammatory pathophysiology has long been suspected. This pilot study aims to detect, whether there are any abnormalities of inflammatory markers associated with childhood and neonatal stroke. METHODS The concentration of 23 different metalloproteinases (MMPs), tissue inhibitors of MMPs (TIMPs), endothelial factors, vascular cell adhesion proteins, and cytokines in plasma were measured in 12 children with AIS, 7 healthy age matched controls and 6 full term neonates with perinatal AIS. RESULTS At the time of the acute event children with AIS had significantly elevated levels of MMP-9, TIMP4, IL-6, IL-8 and CRP compared to controls (p < 0.05). Except for lower IL-6 and CRP levels the pattern of children with a history of varizella-zoster virus (VZV) and other viral infections did not differ to the non-infectious group. Median levels of MMP-1, MMP-2, TIMP-1, TIMP-2, sE-selectin, sICAM-1, sVCAM-1, IL-8, IL-10, TNF-alpha, VEGF, Fetuin A were found to be higher in the neonatal group when compared with older children. CONCLUSION This pilot study supports the assumption of an inflammatory process and up-regulation of metalloproteinases and their inhibitors, and altered pattern of circulating pro-inflammatory cytokines, CRP and vWF levels in pediatric and neonatal AIS. It highlights the feasibility but also difficulties for similar larger future studies that should aim to clarify childhood stroke etiopathogenesis and consecutive further therapeutic options.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases > Research
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine > Neuropaediatrics
04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases

UniBE Contributor:

Bürki, Sarah Elisabeth; Grandgirard, Denis; Leib, Stephen and Steinlin, Maja

Subjects:

500 Science > 570 Life sciences; biology
600 Technology > 610 Medicine & health

ISSN:

1090-3798

Publisher:

Elsevier

Funders:

Organisations 162583 not found.
[4] Swiss National Science Foundation

Language:

English

Submitter:

André Schaller

Date Deposited:

02 May 2016 11:34

Last Modified:

08 Feb 2017 20:06

Publisher DOI:

10.1016/j.ejpn.2015.12.006

PubMed ID:

26778232

Uncontrolled Keywords:

Arterial ischemic stroke; Biomarker; Inflammation; Metalloproteinases; Pediatrics

BORIS DOI:

10.7892/boris.79370

URI:

https://boris.unibe.ch/id/eprint/79370

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