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Open Access 01-12-2016 | Research

Early ficolin-1 is a sensitive prognostic marker for functional outcome in ischemic stroke

Authors: R. Zangari, E. R. Zanier, G. Torgano, A. Bersano, S. Beretta, E. Beghi, B. Casolla, N. Checcarelli, S. Lanfranconi, A. Maino, C. Mandelli, G. Micieli, F. Orzi, E. Picetti, M. Silvestrini, N. Stocchetti, B. Zecca, P. Garred, M. G. De Simoni, the LEPAS group

Published in: Journal of Neuroinflammation | Issue 1/2016

Abstract

Background

Several lines of evidence support the involvement of the lectin pathway of complement (LP) in the pathogenesis of acute ischemic stroke. The aim of this multicenter observational study was to assess the prognostic value of different circulating LP initiators in acute stroke.

Methods

Plasma levels of the LP initiators ficolin-1, -2, and -3 and mannose-binding lectin (MBL) were measured in 80 stroke patients at 6 h only and in 85 patients at 48 h and later. Sixty-one age- and sex-matched healthy individuals served as controls. Stroke severity was measured on admission using the National Institutes of Health Stroke Scale (NIHSS). The outcome was measured at 90 days by the modified Rankin Scale (mRS).

Results

Ficolin-1 was decreased in patients compared with controls measured at 6 h (median 0.13 vs 0.33 μg/ml, respectively, p < 0.0001). At 48 h, ficolin-1 was significantly higher (0.45 μg/ml, p < 0.0001) compared to the 6 h samples and to controls. Likewise, ficolin-2 was decreased at 6 h (2.70 vs 4.40 μg/ml, p < 0.0001) but not at 48 h. Ficolin-3 was decreased both at 6 and 48 h (17.3 and 18.23 vs 21.5 μg/ml, p < 0.001 and <0.05, respectively). For MBL no difference was detected between patients and controls or within patients at the different time points. In multivariate analysis, early ficolin-1 was independently associated with unfavorable mRS outcome (adjusted odds ratio (OR): 2.21, confidence interval (CI) 95 % 1.11–4.39, p = 0.023). Early ficolin-1 improved the discriminating ability of an outcome model including NIHSS and age (area under the curve (AUC) 0.95, CI 95 % 0.90–0.99, p = 0.0001).

Conclusions

The ficolins are consumed within 6 h after stroke implicating activation of the LP. Early ficolin-1 is selectively related to 3-month unfavorable outcome.

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Title: Early ficolin-1 is a sensitive prognostic marker for functional outcome in ischemic stroke
Authors: R. Zangari
E. R. Zanier
G. Torgano
A. Bersano
S. Beretta
E. Beghi
B. Casolla
N. Checcarelli
S. Lanfranconi
A. Maino
C. Mandelli
G. Micieli
F. Orzi
E. Picetti
M. Silvestrini
N. Stocchetti
B. Zecca
P. Garred
M. G. De Simoni
the LEPAS group
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: Journal of Neuroinflammation / Issue 1/2016
Electronic ISSN: 1742-2094
DOI: https://doi.org/10.1186/s12974-016-0481-2

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Springer Medicine

Early ficolin-1 is a sensitive prognostic marker for functional outcome in ischemic stroke

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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