Hypoxia-inducible factor-1α in acute ischemic stroke: neuroprotection for better clinical outcome

急性缺血性中风中的缺氧诱导因子-1α:神经保护以获得更好的临床结果

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作者:Lisda Amalia, Henny Anggraini Sadeli, Ida Parwati, Ahmad Rizal, Ramdan Panigoro

Background

Hypoxia-inducible factor-1α (HIF-1α) is a transcription factor which maintains cellular homeostasis in response to hypoxia. It can trigger apoptosis while stimulating angiogenesis process and decrease neurological deficit after an ischemic stroke. Up until now, this protein complex has not been widely investigated especially in stroke patient.

Conclusions

HIF-1α has a strong correlation with NIHSS and it may be used as predictor in acute ischemic stroke outcome.

Methods

Serum HIF-1α were measured in acute ischemic stroke patients. National Institute of Health Stroke Scale (NIHSS) were assessed on the admission and discharge day (between days 7 and 14). Ischemic stroke divided into 2 groups: large vessel disease (LVD, n = 31) and small vessel disease (SVD, n = 27). Statistical significances were calculated with Spearman rank test.

Objective

Here, we examined the potential of HIF-1α as a marker for neuroplasticity process after ischemic stroke.

Results

A total of 58 patients, 31 with large artery atherosclerosis LVD and 27 with small vessel disease (SVD) were included in this study. HIF-1α level in LVD group was 0.5225 ± 0.2459 ng/mL and in SVD group was 0.3815 ± 0.121 ng/mL. HIF-1α was higher (p = 0.004) in LVD group than in SVD group. The initial NIHSS score in LVD group was 15.46 ± 2.61 and discharge NIHSS score was 13.31 ± 3.449. Initial NIHSS score in SVD group was 6.07 ± 1.82 and the discharge NIHSS was 5.703 ± 1.7055. In both SVD and LVD group, HIF-1α were significantly correlated with initial NIHSS (both p < 0.001) and discharge NIHSS (p < 0.0383 r = 0.94, p < 0.001, r = 0.93, respectively). Conclusions: HIF-1α has a strong correlation with NIHSS and it may be used as predictor in acute ischemic stroke outcome.

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