Objective: To investigate whether Chinese medicine (CM) syndrome is associated with particular molecular mechanism, we explored the correlation between CM syndrome and changes of intercellular adhesion molecule-1 (ICAM-1), matrix metalloproteinase 9 (MMP-9) and heat shock protein 70 (HSP70) in patients with ischemic stroke, which were reported to play an important role in the inflammatory and apoptosis cascade.
Methods: CM syndrome factors of 175 patients with ischemic stroke were assessed using Ischemic Stroke CM Syndrome Factor Diagnostic Scale (ISTSFDS). The patients were grouped according to the main syndrome factor combinations at different time points based on distribution probability of syndrome factor combinations. Blood levels of ICAM-1, MMP-9 and HSP70 were quantified by enzyme-linked immunosorbent assay.
Results: ICAM-1 expression was significantly higher in the internal-wind+phlegm-dampness+blood-stasis, phlegmdampness+ blood-stasis, internal-fire+phlegm-dampness+blood-stasis group than that in the blood-stasis+qideficiency group within 72 h from stroke onset (P <0.05); HSP70 expression was significantly lower in the phlegm-dampness+blood-stasis, internal-fire+phlegm-dampness+blood-stasis, blood-stasis group than that in the phlegm-dampness+blood-stasis+qi-deficiency group on the 7th day from stroke onset (P<0.05).
Conclusions: Phlegm-dampness and blood-stasis exist through the whole process of ischemic stroke. An increased level of ICAM-1 and a reduced level of HSP70 reflect the pathological state of phlegm-stasis mutual binding. These results suggest that inflammation and apoptosis induced by cerebral vascular injury in the pathological processes of ischemic stroke are more prominent in the excess syndrome state like phlegm-dampness and blood-stasis.