Biomarkers of Inflammation in Pediatric Arterial Ischemic Stroke

Abstract

Schmitt-Mechelke T et al.; Swiss Neuropediatric Stroke Registry Study Group. Inflammatory markers in pediatric stroke: an attempt to better understanding the pathophysiology. Eur J Paediatr Neurol 2016 Mar;20(2):252–60. Investigators from Switzerland studied inflammatory markers in children and neonates with acute arterial ischemic stroke (AIS). Twelve children and 6 term neonates with AIS were recruited through the Swiss Neuropediatric Stroke Registry program. Twenty-three inflammatory markers were analyzed. Results for children with AIS were compared to age-matched healthy controls. In childhood AIS, significantly higher concentrations of: MMP-9 (p = 0.04), TIMP-4 (p = 0.002), IL-6 (p = 0.003), IL-8 (p= 0.04), and CRP (p = 0.007) were seen than in controls. Stroke was associated with cerebral arteriopathy in 10 of 12 cases (83%). Five of the 12 children (42%) had VZV infection in the six months prior to AIS. These patients had significantly lower levels of IL-6 and CRP compared to the remaining seven without recent VZV infection, though still elevated compared to controls. There were significant differences in levels of MMP-1, MMP-2, TIMP-1, TIMP-2, TIMP-4 sE-selectin, sICAM-1, sVCAM-1, IL-8, IL-10, TNFα, VEGF, Fetuin and haptoglobin measured in neonates was compared to older children with AIS. The authors propose there is a pro-inflammatory state with specific biomarker elevations associated with acute arterial ischemic stroke in both pediatric and neonatal populations. It is unclear if inflammation is an aspect of the pathophysiology of stroke, or a consequence of tissue injury. [1]