Open Access Research article

Interleukin-10 facilitates the selection of patients for systemic thrombolysis

Manuel Rodríguez-Yáñez1, Mar Castellanos2, Tomás Sobrino1, David Brea3, Pedro Ramos-Cabrer1, Salvador Pedraza4, José A Castiñeiras5, Joaquín Serena2, Antonio Dávalos3, José Castillo1 and Miguel Blanco16*

Author Affiliations

1 Department of Neurology, Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario, Universidad de Santiago de Compostela, IDIS, Santiago de Compostela, Spain

2 Department of Neurology, Hospital Universitario Doctor Josep Trueta, Girona, Spain

3 Department of Neurology, Hospital Universitario Germans Trias i Pujol, Universidad Autónoma de Barcelona, Barcelona, Spain

4 Department of Radiology (Institut de Diagnostic per la Imatge [IDI]), Hospital Universitario Doctor Josep Trueta, IDIBGi, Girona, Spain

5 Department of Neuroradiology, Hospital Clínico Universitario, Santiago de Compostela, Spain

6 Universidad de Santiago de Compostela, IDIS, Santiago de Compostela, Spain

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BMC Neurology 2013, 13:62  doi:10.1186/1471-2377-13-62

Published: 17 June 2013

Abstract

Background

Clinical-Diffusion mismatch (CDM; NIHSS score ≥8 & DWI lesion volume ≤25 mL) and Perfusion-Diffusion mismatch (PDM; difference >20% between initial DWI and MTT lesion volumes) have been proposed as surrogates for ischemic brains that are at risk of infarction. However, their utility to improve the selection of patients for thrombolytic treatment remains controversial. Our aim was to identify molecular biomarkers that can be used with neuroimaging to facilitate the selection of ischemic stroke patients for systemic thrombolysis.

Methods

We prospectively studied 595 patients with ischemic stroke within 12 h of the stroke onset. A total of 184 patients received thrombolytic treatment according to the SITS-MOST criteria. DWI and MTT volumes were measured at admission. The main outcome variable was good functional outcome at 3 months (modified Rankin scale <3). Serum levels of glutamate (Glu), IL-10, TNF-α, IL-6, NSE, and active MMP-9 also were determined at admission.

Results

Patients treated with t-PA who presented with PDM had higher IL-10 levels at admission (p < 0.0001). In contrast, patients with CDM had higher levels of IL-10 (p < 0.0001) as well as Glu and TNF-α (all p < 0.05) and lower levels of NSE and active MMP-9 (all p < 0.0001). IL-10 ≥ 30 pg/mL predicts good functional outcome at 3 months with a specificity of 88% and a sensitibity of 86%. IL-10 levels ≥30 pg/mL independently in both patients with PDM (OR, 18.9) and CDM (OR, 7.5), after an adjustment for covariates.

Conclusions

Serum levels of IL-10 facilitate the selection of ischemic stroke patients with CDM and PDM for systemic thrombolysis.

Keywords:
Ischemic stroke; Thrombolysis; Interleukin-10; MRI