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Hypoxia-induced factor-1α and markers of inflammation in patients with ischemic stroke

https://doi.org/10.15789/1563-0625-HIF-2740

Abstract

Ischemic stroke (IS) occurs as a result of local disturbance of hemocirculation and hypoxia in the brain tissue. Hypoxia-inducible factor-1α (HIF-1α), which is involved in the regulation of tissue oxygen levels, plays an important role in the pathophysiology of stroke, including neuronal survival, neuroinflammation, angiogenesis, glucose metabolism, blood-brain barrier permeability, and is important in IS outcomes. The purpose of the study was to determine the relationship between blood levels of HIF-1α and the degree of neurological deficit in the acute period of IS and the outcome of the disease. We examined 58 people with IS aged 73 (67-81) years. Patients were divided into two groups – discharged and dead. The severity of stroke (NIHSS), neurological deficit, comorbidity index, blood levels of HIF-1α, p53 protein, interleukin-6, cystatin C, CRP, creatinine, hematological parameters were determined at admission, on days 3 and 10 of the disease. At admission the blood levels of HIF-1α was lower than in the comparison group and remained reduced until the 10th day. On day 10 the association of HIF-1α with neurological deficit, comorbidity index and disease outcome was determined. We observed a feedback of HIF-1α with the content of erythrocytes, hemoglobin and hematocrit, which can be regarded as a reflection of the hemic component of mixed hypoxia. In dead patients, an increased blood level of cystatin C was detected, which was associated with HIF-1α concentrations. In all periods of observation of IS, a correlation between cystatin C and creatinine and CRP levels was noted. These results may indicate dysfunction of endotheliocytes, inflammation associated with hypoxia in IS. The prognostic significance of the blood level of HIF-1α on the 10th day for the outcome of IS was AUC = 0.900. Blood levels of HIF-1α in the acute period was associated with the severity of IS and the outcome of the disease.

About the Authors

L. P. Pivovarova
I. Dzhanelidze Research Institute of Emergency Medicine
Russian Federation

Pivovarova L.P., PhD, MD (Мedicine), Head, Laboratory Diagnostics Department 

St. Petersburg



I. A. Voznyuk
First St. Petersburg State I. Pavlov Medical University
Russian Federation

Voznyuk I.A., PhD, MD (Мedicine), Professor, Chief Freelance Specialist-Neurologist of the Health Committee of St. Petersburg and the Ministry of Health in the NorthWestern Federal District, Professor of the Department of Neurology, Deputy Chief Physician for Neurology 

St. Petersburg



I. V. Osipova
I. Dzhanelidze Research Institute of Emergency Medicine
Russian Federation

Osipova I.V., PhD (Мedicine), Senior Research Associate, Laboratory Diagnostics Department 

St. Petersburg



O. B. Ariskina
I. Dzhanelidze Research Institute of Emergency Medicine
Russian Federation

Ariskina O.B., PhD (Biology), Research Associate, Laboratory Diagnostics Department 

St. Petersburg



E. A. Gogoleva
I. Dzhanelidze Research Institute of Emergency Medicine
Russian Federation

Gogoleva E.A., PhD (Мedicine), Senior Research Associate, Head, Neurological Department for Patients with Stroke 

St. Petersburg



M. V. Prokhorova
I. Dzhanelidze Research Institute of Emergency Medicine
Russian Federation

Prokhorova M.V., Junior Research Associate, Neurological Department for Patients with Stroke 

St. Petersburg



N. G. Karpova
I. Dzhanelidze Research Institute of Emergency Medicine
Russian Federation

Karpova N.G., Doctor of Clinical Laboratory Diagnostics, Сlinical Diagnostic Laboratory 

St. Petersburg



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For citations:


Pivovarova L.P., Voznyuk I.A., Osipova I.V., Ariskina O.B., Gogoleva E.A., Prokhorova M.V., Karpova N.G. Hypoxia-induced factor-1α and markers of inflammation in patients with ischemic stroke. Medical Immunology (Russia). 2023;25(4):991-996. https://doi.org/10.15789/1563-0625-HIF-2740

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ISSN 1563-0625 (Print)
ISSN 2313-741X (Online)