Study on the expression changes and clinical significance of ICAM-1, MMP-9, and Gal-3 in patients with ischemic stroke.

Abstract

Background: To explore the relationship between serum intercellular adhesion molecule-1 (ICAM-1), matrix metalloproteinase-9 (MMP-9), galectin-3 (Gal-3) and ischemic stroke, cerebral infarct volume, and neurological symptoms, and to evaluate their combined predictive value for poor prognosis.

Methods: This observational case-control study enrolled 126 patients with cerebral infarction who were divided into small volume group, medium volume group, and large volume group based on infarct volume. Patients were also categorized into mild, moderate, and severe groups according to neurological deficit severity. In addition, 46 healthy subjects were recruited as the control group. Serum levels of ICAM-1, MMP-9, and Gal-3 were measured using enzyme-linked immunosorbent assay. Statistical analysis was performed using one-way ANOVA with post-hoc comparison testing, and ROC curve analysis was conducted to determine sensitivity and specificity.

Results: Compared with the control group, serum ICAM-1, MMP-9, and Gal-3 levels increased significantly with increasing cerebral infarction volume in patients with cerebral infarction. Compared with the control group, serum ICAM-1, MMP-9, and Gal-3 levels increased significantly with increased neurological deficit in patients with cerebral infarction. Serum ICAM-1, MMP-9, and Gal-3 were significantly positively correlated with the volume of cerebral infarction and degree of neurological deficit for ischemic stroke. The AUC values for serum ICAM-1, MMP-9, and Gal-3 independently and in combination when predicting poor prognosis of patients with ischemic stroke were 0.805, 0.809, 0.815, and 0.917, respectively, with sensitivities of 80.23%, 81.50%, 78.26%, and 90.33%, respectively, and specificities of 75.26%, 70.10%, 76.20%, and 78.47%, respectively. The relevant cutoff values for these biomarkers were displayed to enable clinical application. The clinical value of these three indicators in combined detection showed a higher predictive performance than individual marker detection when predicting the poor prognosis of ischemic stroke.

Conclusions: Serum ICAM-1, MMP-9, and Gal-3, which are all closely associated with cerebral infarction volumes and neurological deficit, appear to be very promising markers in patients with ischemic stroke. By documenting and exploring the dynamic changes of these three biomarkers in patients with stroke, we could not only enhance our understanding of the pathophysiological mechanism of ischemic stroke but also provide another scientific basis for early diagnosis, disease monitoring, and prognostic evaluations.