Predictive Markers of Blood Cytokine and Chemokine in Recurrent Brain Infarction

The mechanism of the inflammatory response in the vascular wall in atherothrombosis and during the progression of atherosclerosis has attracted attention. We focused on the potential usefulness of inflammatory markers in chronic recurrent brain infarction, and analyzed the role of inflammatory markers in atherosclerosis of the intracranial artery. The subjects were 2 groups of patients treated between 2004 and 2006: a group of outpatients with recurrent infarction (group RI), who developed atherothrombotic brain infarction twice; another group of outpatients with brain infarction without recurrence (group BI), who developed brain infarction once and remained free of recurrence for >1 year; and a group of control subjects with normal brain magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) (group C). Plasma samples were collected from each group of patients for the simultaneous measurement of 17 kinds of candidate inflammatory markers, using a fluorescent microbead array system, and the results were compared with head MRA findings. The levels of high-sensitivity C-reactive protein (hsCRP) and monocyte chemoattractant protein-1 (MCP-1) were significantly higher in group RI patients than in groups C and BI. Subjects with a hsCRP level >= 0.3 and a MCP-1 level >= 200 in the serum have, respectively, a 1.92 and 2.98 relative risk to have a potential recurrent infarction. Regarding the relation of inflammatory marker levels with MRA findings, group RI showed significantly higher levels of hsCRP at M1 lesions and MCP-1 at A1 and M1 lesions than group BI (P < 0.05). In conclusion, the MCP-1 level as well as hsCRP in the blood can be a potential predictive marker of recurrent thrombotic brain infarction, and may reflect inflammation that promotes intracranial large-artery atherosclerosis.