Strong complement activation after acute ischemic stroke is associated with unfavorable outcomes

Atherosclerosis. 2009 May;204(1):315-20. doi: 10.1016/j.atherosclerosis.2008.07.044. Epub 2008 Aug 14.

Abstract

Objective: According to data from animal models, complement activation plays a major role in the brain injury after acute ischemic stroke. Scarce findings are, however, available on the detection of complement activation products in stroke patients.

Methods: We have measured plasma levels of the five complement activation products (C1rC1sC1inh, C4d, C3a, C5a and SC5b-9) in samples of 26 patients with ischemic stroke upon admission. Twenty-six patients with severe carotid atherosclerosis served as patient controls.

Results: Levels of two activation products (SC5b-9 and C4d)) were significantly elevated in the plasma of stroke patients, SC5b-9 levels, exhibited significant positive correlation with the clinical severity of stroke, the severity of neurological deficit, as well as with the level of functional disability.

Conclusion: These findings suggest that complement activation plays an active role in the development of brain infarct. The measurement of complement activation products might help to determine the clinical prognosis after acute ischemic stroke. Furthermore, there is potential usefulness of complement modulating therapy in ischemic stroke.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Brain Ischemia / complications
  • Brain Ischemia / genetics
  • Brain Ischemia / immunology*
  • C-Reactive Protein / metabolism
  • Case-Control Studies
  • Cerebral Infarction / diagnosis
  • Cerebral Infarction / genetics
  • Cerebral Infarction / immunology*
  • Complement Activation*
  • Complement C1 Inactivator Proteins / metabolism
  • Complement C1 Inhibitor Protein
  • Complement C1r / metabolism
  • Complement C3a / metabolism
  • Complement C4b
  • Complement C5a / metabolism
  • Complement Membrane Attack Complex / metabolism
  • Disability Evaluation
  • Female
  • Humans
  • Male
  • Mannose-Binding Lectin / genetics
  • Middle Aged
  • Peptide Fragments / blood
  • Prognosis
  • Severity of Illness Index
  • Stroke / diagnosis
  • Stroke / genetics
  • Stroke / immunology*
  • Time Factors

Substances

  • Biomarkers
  • Complement C1 Inactivator Proteins
  • Complement C1 Inhibitor Protein
  • Complement Membrane Attack Complex
  • MBL2 protein, human
  • Mannose-Binding Lectin
  • Peptide Fragments
  • SC5b-9 protein complex
  • SERPING1 protein, human
  • Complement C3a
  • Complement C4b
  • complement C4d
  • Complement C5a
  • C-Reactive Protein
  • Complement C1r