Post-Stroke Infection: A Role for IL-1ra?

作者：Tanzi Pat; Cain Kevin; Kalil Angela; Zierath Dannielle; Savos Anna; Gee J Michael; Shibata Dean; Hadwin Jessica; Carter Kelly; Becker Kyra^*

来源：Neurocritical Care, 2011, 14(2): 244-252.

DOI：10.1007/s12028-010-9490-7

• Stroke
• IL-1ra
• Infection
• IL-10
• Cortisol

Infection is common following stroke and is independently associated with worse outcome. Clinical studies suggest that infections occur more frequently in those individuals with stroke-induced immunologic dysfunction. This study sought to explore the contribution of immunomodulatory cytokines and hormones to lymphocyte function and infection risk.
Patients (N = 112) were enrolled as soon as possible after the onset of ischemic stroke. Blood was drawn to assess plasma cortisol, IL-10, IL-1ra, lymphocyte numbers, and lymphocyte function at 72 h after stroke onset; infections were censored through 21 days after stroke onset.
Infection occurred in 25% of patients. Stroke severity was the most important predictor of infection risk. Increased plasma cortisol, IL-10, and IL-1ra, as well as decreased lymphocyte numbers, at 72 h after stroke onset were associated with risk of subsequent infection. After controlling for stroke severity, only IL-1ra was independently associated with infection risk, and the degree of risk was consistent throughout the post-stroke period. Infection, but not IL-1ra itself, was associated with worse outcome at 3 months.
In this study cohort, increased plasma IL-1ra was independently associated with the risk of post-stroke infection. Further studies are needed to validate this finding, which could have important implications for stroke therapy.

• 出版日期2011-4