Can CRP affect the blood-brain barrier during acute ischemic stroke?

Authors

  • Joanna Bielewicz Department of Neurology, Medical University of Lublin, Poland Author
  • Jacek Kurzepa Department of Medical Chemistry, Medical University of Lublin, Poland Author
  • Elżbieta Czekajska-Chehab 1st Department of Radiology, Medical University of Lublin, Poland Author
  • Piotr Kamieniak Department of Neurosurgery, Medical University of Lublin, Poland Author
  • Beata Daniluk Institute of Psychology, University of Marie Curie-Skłodowska, Poland Author
  • Halina Bartosik-Psujek Department of Neurology, Medical University of Lublin, Poland Author

DOI:

https://doi.org/10.1515/pjph-2015-0033

Keywords:

CRP, ischemic stroke, S100BB protein, blood-brain barrier

Abstract

Introduction. Ischemic strokes (IS) are one of the main causes of death and disabilities around the globe. Therefore, there is a huge need for researching the pathogenesis of IS. The C-reactive protein (CRP) plays a role during inflammatory processes. Results of some studies conducted on animal models indicate that CRP affects the blood-brain barrier (BBB) stability during IS. The presence of S100BB protein can be considered as an indication of BBB injury.

Aim. The purpose of this study was to discover the relationship between CRP and S100BB protein.

Material and methods. The study looked at fifty four IS patients, with the disease confirmed by computer tomography (CT). The clinical status was evaluated on the 1st, 3rd, 5th, 10th day and 3 months following the onset of IS. Neurological status was estimated using the National Institute of Health Stroke Scale (NIHSS). Patients’ disability level was determined, using Modified Rankin Scale (mRS) and Barthel Index (BI). The volume of ischemic focus was calculated on the 10th day after the stroke, using CT. The levels of CRP and S100BB were evaluated on 1st, 3rd, 5th and 10th day after the stroke onset with usage of ELISA method.

Results. The mean level of CRP and its concentration on the 1st, 3rd, 5th and 10th day directly correlates with a deteriorated clinical status, as measured with the use of NIHSS, BI and mRS on day 10 and 3 months after the onset of IS. We found a correlation with the mean CRP level and bigger volume of ischemic injury. The mean CRP level correlated with the mean level of S100BB protein. In the group of patients with low CRP (0.51-24.68 mg/mL) the level of S100BB and the volume of ischemic focus were lower than in the group with a high level of CRP (24.69-209 mg/mL).

Conclusions. CRP can be considered as a predictor of a worse clinical outcome after stroke. The relationship between CRP and S100BB protein can suggest the active role of CRP during IS.

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Published

2015-08-12