Acute astrocytic reaction is associated with 3-month functional outcome after stroke treated with endovascular therapy.

IF 5.8 3区医学 Q1 CLINICAL NEUROLOGY

European Stroke Journal Pub Date : 2024-06-06 DOI:10.1177/23969873241256813

Ada Boutelier, Véronique Ollivier, Mikael Mazighi, Maeva Kyheng, Julien Labreuche, Nahida Brikci-Nigassa, Mialitiana Solo Nomenjanahary, Francois Delvoye, Benjamin Maier, Claire Paquet, Benoit Ho-Tin-Noe, Jean-Philippe Desilles

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引用次数: 0

Abstract

Introduction: More than 50% of large vessel occlusion (LVO) acute ischemic stroke (AIS) patients treated with endovascular therapy (EVT) remain severely disabled at 3 months. We hypothesized that acute astrocytic inflammatory response may play a pivotal role in post-AIS brain changes associated with poor functional outcome. We proposed to evaluate the level of YKL-40, a glycoprotein mainly released by reactive astrocytes.

Patients and methods: A monocentric prospective cohort study was conducted on consecutive LVO AIS patients treated with EVT. Three blood samples (before, within 1 and 24-hour post-EVT) were collected to measure plasma YKL-40 concentrations. Functional outcome was assessed according to the modified Rankin Scale (mRS) score at 3 months.

Results: Between 2016 and 2020, 120 patients were included. The plasma concentration of YKL-40 before EVT was statistically and independently associated with 3-month worse functional outcome (adjusted cOR, 1.59; 95% CI [1.05-2.44], p = 0.027) but not the two following samples 1-hour and 24-hour post-EVT. Accordingly, we found that excellent functional outcome was associated with a lower level of YKL-40 before and within 1 h after EVT (p = 0.005 and p = 0.003, respectively) but not when measured 24 h after EVT (p = 0.2).

Discussion and conclusion: This study suggests that the astrocytic reaction to acute brain hypoxia, especially before recanalization, is associated with worse functional outcome. Such early biomarker of the astrocytic response in AIS may optimize individualized care in the future.

Clinical trial registration-url: http://www.clinicaltrials.gov. Unique identifier: NCT02900833.

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急性星形胶质细胞反应与血管内治疗脑卒中后 3 个月的功能预后有关。

导言：在接受血管内治疗（EVT）的大血管闭塞（LVO）急性缺血性脑卒中（AIS）患者中，超过 50%的患者在 3 个月后仍然严重残疾。我们推测，急性星形胶质细胞炎症反应可能在与不良功能预后相关的 AIS 后脑部变化中起着关键作用。我们提议评估YKL-40的水平，这是一种主要由反应性星形胶质细胞释放的糖蛋白：对连续接受 EVT 治疗的 LVO AIS 患者进行了单中心前瞻性队列研究。收集了三次血液样本（EVT前、EVT后1小时内和24小时内），以测量血浆中YKL-40的浓度。根据3个月后的改良Rankin量表（mRS）评分评估功能预后：结果：2016年至2020年间，共纳入120名患者。EVT前的血浆YKL-40浓度与3个月后较差的功能预后有统计学上的独立相关性（调整后的cOR，1.59；95% CI [1.05-2.44]，p = 0.027），但与EVT后1小时和24小时后的两个样本无关。因此，我们发现良好的功能预后与EVT前和EVT后1小时内较低的YKL-40水平相关（分别为p = 0.005和p = 0.003），但与EVT后24小时的测量结果无关（p = 0.2）：本研究表明，星形胶质细胞对急性脑缺氧的反应，尤其是在再通之前，与较差的功能预后有关。这种AIS星形胶质细胞反应的早期生物标志物可优化未来的个体化治疗。临床试验注册-url：http://www.clinicaltrials.gov。唯一标识符：NCT02900833。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Stroke Journal Multiple-

CiteScore

7.50

自引率

6.60%

发文量

102

期刊介绍： Launched in 2016 the European Stroke Journal (ESJ) is the official journal of the European Stroke Organisation (ESO), a professional non-profit organization with over 1,400 individual members, and affiliations to numerous related national and international societies. ESJ covers clinical stroke research from all fields, including clinical trials, epidemiology, primary and secondary prevention, diagnosis, acute and post-acute management, guidelines, translation of experimental findings into clinical practice, rehabilitation, organisation of stroke care, and societal impact. It is open to authors from all relevant medical and health professions. Article types include review articles, original research, protocols, guidelines, editorials and letters to the Editor. Through ESJ, authors and researchers have gained a new platform for the rapid and professional publication of peer reviewed scientific material of the highest standards; publication in ESJ is highly competitive. The journal and its editorial team has developed excellent cooperation with sister organisations such as the World Stroke Organisation and the International Journal of Stroke, and the American Heart Organization/American Stroke Association and the journal Stroke. ESJ is fully peer-reviewed and is a member of the Committee on Publication Ethics (COPE). Issues are published 4 times a year (March, June, September and December) and articles are published OnlineFirst prior to issue publication.