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

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

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • African Americans*
  • Aged
  • Biomarkers / blood
  • Brain Ischemia / blood*
  • Brain Ischemia / complications
  • Brain Ischemia / immunology*
  • Chronic Disease
  • Female
  • Gene Products, tat / blood
  • Humans
  • Inflammation / blood
  • Inflammation / etiology
  • Inflammation Mediators / blood
  • Male
  • Middle Aged
  • Stroke, Lacunar / blood*
  • Stroke, Lacunar / complications
  • Stroke, Lacunar / immunology*
  • Vascular Cell Adhesion Molecule-1 / blood

Substances

  • Biomarkers
  • Gene Products, tat
  • Inflammation Mediators
  • Vascular Cell Adhesion Molecule-1