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Transl Stroke Res. 2015 Dec;6(6):430-6. doi: 10.1007/s12975-015-0424-8. Epub 2015 Sep 15.

Chronic Systemic Immune Dysfunction in African-Americans with Small Vessel-Type Ischemic Stroke.

Author information

1
Department of Neurobiology and Anatomy, Center for Basic and Translational Stroke Research, and Center for Neuroscience, West Virginia University School of Medicine, Box 9128, Morgantown, WV, 26506, USA. cdbrown2@hsc.wvu.edu.
2
Department of Neurology, One Medical Center Boulevard, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA.
3
Department of Biostatistics and Bioinformatics, Duke University Medical Center, Box 2721, Durham, NC, 27110, USA.
4
Department of Neurology and Kentucky Neuroscience Institute, University of Kentucky, 740 S. Limestone Street, Room L445, Lexington, KY, 40536, USA.
5
Department of Neurology, Duke University Medical Center, Box 2900, Durham, NC, 27710, USA.

Abstract

The incidence of small vessel-type (lacunar) ischemic strokes is greater in African-Americans compared to whites. The chronic inflammatory changes that result from lacunar stroke are poorly understood. To elucidate these changes, we measured serum inflammatory and thrombotic biomarkers in African-Americans at least 6 weeks post-stroke compared to control individuals. Cases were African-Americans with lacunar stroke (n = 30), and controls were age-matched African-Americans with no history of stroke or other major neurologic disease (n = 37). Blood was obtained >6 weeks post-stroke and was analyzed for inflammatory biomarkers. Freshly isolated peripheral blood mononuclear cells were stimulated with lipopolysaccharide (LPS) to assess immune responsiveness in a subset of cases (n = 5) and controls (n = 4). After adjustment for covariates, the pro-inflammatory biomarkers, soluble vascular cadherin adhesion molecule-1 (sVCAM-1) and thrombin anti-thrombin (TAT), were independently associated with lacunar stroke. Immune responsiveness to LPS challenge was abnormal in cases compared to controls. African-Americans with lacunar stroke had elevated blood levels of VCAM-1 and TAT and an abnormal response to acute immune challenge >6 weeks post-stroke, suggesting a chronically compromised systemic inflammatory response.

KEYWORDS:

African-Americans; Biomarkers; Chronic inflammation; Lacunar stroke; Race-ethnic disparities; Small vessel disease

PMID:
26373290
PMCID:
PMC4628588
DOI:
10.1007/s12975-015-0424-8
[Indexed for MEDLINE]
Free PMC Article

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