1997 STROKE AWARD

TNF-a in Acute Ischemic Stroke

D.F.Intiso, R.Cioffi, G.Lagioia, P.Di Viesti, C.Checchia De Ambrosioø, P.Crociani,
P.Simone, P.Tonali.
Department of Neurology and Laboratory of Biochemistryø
I.R.C.C.S. "Casa Sollievo della Sofferenza" S.Giovanni Rotondo (Fg), Italy.

Serum level alterations of nervous tissue proteins such as Neuron Specific Enolase (NSE), S-100 Protein (S-100) and of several cytokines including Interleukin-1 (IL-1), Interleukin-6 (IL-6), Neutrophil Proteinase 4 (NP4) have been recently reported in ischemic stroke patients. Tumor Necrosis Factor-alpha (TNF-a) is a multifunctional cytokine mainly produced by activated macrophages. This protein display a key role in immune and inflammatory response but its activity remain unclear. As part of a study on serum markers of ischemic cerebral damage, we performed a preliminary study to ascertain serum level modification of TNF-a in acute ischemic stroke patients.We measured TNF-a concentration in 31 consecutive patients (20F, 11M; mean age 65.1 years) with acute ischemic stroke admitted to our Stroke Unit and in a control group of 30 matched healthy subjects. Stroke patients with fever, inflammatory processes, vasculitis and known immune diseases were excluded . The serum dosage of TNF-a was performed on average 4.5 days after stroke onset. Mean serum level value of TNF-a was 67.5 pg /ml (45.3 SD) in ischemic stroke group and 10.6 pg/ml (12 SD) in control group (p< 0.002). These preliminar data suggest that patients with acute ischemic stroke can show early increased serum level of TNF-a, but many questions remain unsolved still. Therefore, we started a study which is in progress to ascertain serial serum changes of TNF-a; NSE; S-100; IL-1; IL-6 in acute ischemic stroke patients and to evaluate if the neurological impairment, the extension of brain damage and outcome at 30 days after cerebral ischemia present a correlation with serum level of those cytokines. The results could contribute to a better understanding of physiopathological mechanism underlying cerebral ischemia and to permit the development of new therapeutic strategies in acute stroke.

Department of Neurology and Laboratory of Biochemistry

I.R.C.C.S. "Casa Sollievo della Sofferenza" S.Giovanni Rotondo.

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