Relevance. 100-110 000 acute disorders of cerebral circulation are registered in Ukraine annually, about 57% of which are ischemic stroke (IS). Study of dynamics of the neuronal damage markers level and their correlation with oxidative stress indicators may be informative for estimating the prognosis of the IS recovery period.
Objective: to study the features of of neuronal damage markers level, the pro- and antioxidant systems status and their effect on the of neurological deficiency manifestations and the functional status of post stroke patients.
Materials and methods. 120 patients in the early recovery period of first-ever hemispheric atherothrombotic IS were examined. The control group (CG) included 20 healthy individuals, representative by age and gender. Assessment of neurological deficiency and functional status of patients was performed with the help of the NIHSS scale, the Scandinavian Stroke Scale (SSS), the modified Rankin Scale (mRS) and the Bartel Index (BI). The level of neuron-specific enolase (NSE) in serum was determined by enzyme-linked immunosorbent assay. The determination of the level of oxidative protein modification (OPM) products in serum, glutathione reductase (GR) and glutathione peroxidase (GP) activity was performed spectrophotometrically. Statistical processing of the results was carried out using Statistica 6.0 statistical analysis package (StatSoft, Inc.) with the help of nonparametric results estimation methods.
Results. In patients after 1 month after IS an increase of AFGn (356 nm) content by 33.9% (p<0.05) compared to CG was observed. KFGn (370 nm) level was increased by 26.0% (p<0.05), AFGo (430 nm) - by 76.2% (p<0.01), CFG (530 nm) - 125.0% (p<0.01). The general OPM products was 37.0% higher than in CG (p<0.05), while the activity of GP and GR decreased by 31.6% and 28.6%, respectively (p<0, 05), and the NSE level was increased by 150.6% (p<0.05).
The NIHSS score correlated with the level of AFGn (356 nm) (r=0.24; p=0.032), KFGo (530 nm) (r=0.41; p=0.047) and the general OPM products level (r=0.25 ; p=0.039), whereas the GR activity significantly influenced the NIHSS score (r=-0.27; p=0.048), SSS score (r=0.23; p=0.034) and BI (r=0.31; p=0.038). Also significant correlations were found between the NSE level and the concentration of all OPM products, GP ans GR activity.
Conclusions. The NSE level increase is characteristic for the post stroke patients, which correlates with the degree of neurological deficiency manifestations and the patients’ functional status. The NSE level increases due to the increase of OPM products concentration and the decrease of GP and GR activity, which may indicate a worsening of the neuronal damage degree, linked to the pro- and antioxidant systems imbalance. These processes adversely affect the functional status of patients, with the greatest influence of the KFGo (530 nm) concentration, the general OPM products level and the GR activity.
2. Mishchenko V.M., Sokolyk V.V. [Brain small vessels disease (neuroimaging and biochemical markers)] // Ukrainian Journal of Psychoneurology. 2014; 22 (4): 41-5. [in Russian]. URL: http://uvnpn.com.ua/upload/iblock/567/56744896b234896b86df669f0ecd9992.pdf
3. Mishchenko T.S. Epidemiology of cerebrovascular diseases and organization of medical care for patients with stroke in Ukraine // Ukrainian Journal of Psychoneurology. 2017; 25 (1): 22-4. [in Russian]. URL: http://uvnpn.com.ua/upload/iblock/871/8710f7dfba63e16a500a82d17123f077.pdf
4. Muravleva LE, Molotov-Luchansky VB, Klyuev DA, Bakenova RA, Kultanov B.Zh., Tankibayeva NA, Koikov VV, Omarova GA. Oxidative Modification of Proteins: Problems and Prospects for Research // Fundamental Research. 2010; 1: 74-8. [in Russian]. URL: https://www.fundamental-research.ru/ru/article/view?id=1617
5. Bharosay A., Bharosay V.V., Varma M. et al. Correlation of brain biomarker neuron specific enolase (NSE) with degree of disability and neurological worsening in cerebrovascular stroke // Indian Journal of Clinical Biochemistry. 2012; 27 (2): 186-90. https://doi.org/10.1007 / s12291-011-0172-9.
6. De Marchis G.M., Dankowski T., König I.R., et al. A novel biomarker-based prognostic score in acute ischemic stroke: The CoRisk score // Neurology. 2019; 92 (13): e1517-e1525. https://doi.org/10.1212 / WNL.0000000000007177.
7. Dogan O., Kisa U., Erdemoglu A. et al. Oxidative and nitrosative stress in patients with ischemic stroke // J. Laboratory Medicine. 2018; 42 (5): 195-200. https://doi.org/10.1515/labmed-2018-0036.
8. Gandolfi M., Smania N., Vella N., Picelli S., Chirumbolo S. Assessed and Emerging Biomarkers in Stroke and Training-Mediated Stroke Recovery: State of the Art // Neural Plasticity. 2017, Article ID 1389475: 15 p. https://doi.org/10.1155/2017/1389475.
9. Katan M., Elkind M. The potential role of blood biomarkers in patients with ischemic stroke: An expert opinion // Clinical & Translational Neuroscience. 2018: 1-7. https://doi.org/10.1177/2514183X18768050.
10. Komsiiska D. Oxidative stress and stroke: a review of upstream and downstream antioxidant therapeutic options // Comparative Clinical Pathology. 2019; 28 (4): 915-26. https://doi.org/10.1007/s00580-019-02940-z.
11. Krishnamurthi R.V., Moran A.E., Feigin V.L. et al. Stroke prevalence, mortality and disability-adjusted life years in adults aged 20-64 years in 1990-2013: data from the global burden of disease 2013 study // Neuroepidemiology. 2015; 45 (3): 190-202. https://doi.org/10.1159 / 000441098.
12. Makris K., Haliassos A., Chondrogianni M., Tsivgoulis G. Blood biomarkers in ischemic stroke: potential role and challenges in clinical practice and research // Critical Reviews in Clinical Laboratory Sciences. 2018; 55:5: 294-328. https://doi.org/10.1080/10408363.2018.1461190.
13. Peizhong M. Oxidative Stress and Its Clinical Applications in Dementia. Journal of Neurodegenerative Diseases. 2013: Article ID 319898: 15 p. https://doi.org/10.1155/2013/319898.
14. Salim S. Oxidative stress and psychological disorders // Current Neuropharmacology. 2014; 12 (2): 140-7. https://doi.org/10.2174/ 1570159X11666131120230309
15. Žitňanová I., Šiarnik P., Kollár B. et al. Oxidative Stress Markers and Their Dynamic Changes in Patients after Acute Ischemic Stroke. Oxidative Medicine and Cellular Longevity. 2016: Article ID 9761697: 7 p. https://doi.org/10.1155/2016/9761697.
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