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Sphingosine-1-phosphate (S1P) regulates cell survival, lymphocyte migration and endothelial barrier function-all of these processes are affected in acute ischemic stroke
.
Therefore, different S1P receptor agonists have been studied in many experimental stroke models and proved to be beneficial
Therefore, different S1P receptor agonists have been studied in many experimental stroke models and proved to be beneficial
Blood vessel
Clinical trials using fingolimod together with alteplase have shown that fingolimod may reduce reperfusion injury and improve the clinical prognosis of patients with acute ischemic stroke
.
In addition to cerebrovascular diseases, in a nested case-control study, low S1P levels were associated with acute coronary syndrome and myocardial infarction
Despite these previous studies, the relationship between S1P levels and clinical and outcome parameters in patients with acute stroke has not been studied yet
.
In this way, Edzard Schwedhel and others at the University of Hamburg, Germany, explored the potential connection between S1P and clinical parameters and outcomes after acute ischemic stroke
.
In a prospective stroke cohort (MARK-STROKE), 374 patients with acute ischemic stroke or transient ischemic attack were enrolled (mean age: 67.
9±13.
0 years, gender: 64.
7% were males).
Mass spectrometry analysis of serum S1P on admission
.
In addition to the cross-sectional analysis, 79 adverse events (death, stroke, myocardial infarction, rehospitalization) were recorded in 270 patients during the follow-up period
.
Regression analysis adjusted for age, gender, low-density lipoprotein cholesterol, and vascular risk factors
cholesterol
In serum, low S1P was associated with a higher NIHSS score at admission and non-lacunnar infarcts in the anterior circulation determined by multivariate regression analysis
.
During the 294±170 days of follow-up, patients with S1P in the lowest tertile (<1.
33 µmol/L) had more adverse events (Kaplan-Meier analysis, P=0.
048 trend)
.
In the adjusted Cox regression analysis, the lowest tertile of S1P was associated with poorer outcomes after stroke (hazard ratio, HR 0.
51 [95% confidence interval 0.
28-0.
92])
.
These results were confirmed in a separate cohort that low S1P levels were associated with higher NIHSS, larger infarct volume, and poorer results after 90 days
.
This Ge study implies: the harmful effects of low S1P levels in acute stroke, thus supporting the therapeutic potential of S1P mimics
.
.
Original source:
Schwedhelm E, Schwieren L, Tiedt S, et al.
Serum Sphingosine-1-Phosphate Levels Are Associated With Severity and Outcome in Patients With Cerebral Ischemia .
Stroke.
Serum Sphingosine-1-Phosphate Levels Are Associated With Severity and Outcome in Patients With Cerebral Ischemia in this message
