Plasma Interleukin-37 is Elevated in Acute Ischemic Stroke Patients and Probably Associated With 3-month Functional Prognosis 

Abstract

Feng Zhang,1 Tianrui Zhu,1 Heng Li,1 Yi He,2 Yuanyuan Zhang,1 Nana Huang,1 Guitao Zhang,3 Yanshuang Li,1 Dujuan Chang,1 Xiaohong Li1 1Department of Neurology, Jinan Central Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People’s Republic of China; 2Department of Neurology, The Second Affiliated Hospital of Xi’an Medical University, Xi’an, Shanxi, People’s Republic of China; 3Department of Neurology, Capital Medical University Affiliated Beijing Tiantan Hospital, Beijing, People’s Republic of ChinaCorrespondence: Xiaohong Li Email [email protected]: Interleukin-37 is a novel cytokine emerging as a natural suppressor of inflammatory responses. Inflammation and the immune response play important roles in acute ischemic stroke. This study aimed at evaluating the plasma levels and the association with 3-month outcomes of interleukin-37 in acute ischemic stroke patients.Patients and Methods: In total, 152 consecutive patients with acute ischemic stroke and 45 healthy controls were included. Plasma interleukin-37 levels were determined in the first morning after admission using an enzyme-linked immunesorbent assay. The primary outcome was the 3-month functional outcome (modified Rankin Scale score > 2). Logistic regression was used to evaluate the risk and 3-month outcome of stroke according to plasma interleukin-37 level.Results: Plasma interleukin-37 levels were significantly higher in the patients with acute ischaemic stroke than in the healthy controls (182.26 versus 97.89 pg/mL, p< 0.001). Patients with large-artery atherosclerosis had significantly higher IL-37 levels than those with small-artery occlusion (202.12± 35.82 versus 175.67± 33.71pg/mL, p< 0.001). Plasma interleukin-37 levels were positively correlated with National Institutes of Health Stroke Scale scores (r=0.521, p< 0.0001) and lesion volume (r=0.442, p< 0.0001). Ninety-four and 58 patients had favourable and unfavourable 3-month outcomes, respectively. Elevated plasma interleukin-37 levels were independently associated with unfavourable 3-month outcomes (adjusted odds ratio=1.033, p=0.001, 95% confidence interval: 1.015– 1.056).Conclusion: Admission plasma interleukin-37 levels were significantly increased after acute ischemic stroke. Elevated interleukin-37 levels were independently associated with unfavourable 3-month prognoses in acute ischemic stroke patients. Further studies with other populations are needed.Keywords: interleukin-37, acute ischemic stroke, functional outcome, prognosis

Keywords

• interleukin-37
• acute ischemic stroke
• functional outcome
• prognosis.