Introduction : Available reports underline the significance of the inflammatory process in the development, progression and destabilisation of atherosclerotic plaques in the internal carotid artery (ICA). The aim of this study was to evaluate the relationship between the degree of ICA stenosis,...

Acute cerebral ischemia triggers local and systemic immune response. The aims of this project was to assess the blood serum concentration of the markers of inflammation and markers of the blood brain barrier damage on the first day of ischemic stroke, and the mutual correlations between these marker levels. Methods Our prospective study included 138 patients with first-in-life stroke, who were analyzed according to: plasma concentration of the following markers on the first day of stroke: Il-2 and IL-6, S100B, TNF alfa, GRN, NSE, uPA, VEGF, BDNF, CRP, leucocyte and thrombocyte counts; their neurological status on the first day of stroke (NIHSS) and their functional status at 30 days following stroke (mRS). Result The study included 138 patients with mean age: 73.11 ± 11.48 [36-103]. Patients with a higher score on the NIHSS than those obtaining lower scores showed significantly higher concentrations of TNF-alpha, WBC, CRP, NSE, IL-6 and S100B. Patients with a higher score on the mRS than those obtaining lower scores showed significantly higher concentrations of WBC, CRP, GRN, IL-6, S100B. Factors with an independent influence on the neurological status on the first day of stroke were: sex, WBC, PLT, CRP, S100B and IL-6 levels. Atrial fibrillation, leukocyte count, CRP, NSA, uPA, interleukin 6 and S100B showed an independent impact on the functional status on the 30th day of stroke. Patients with symptomatic atherosclerosis of carotid/cerebral and/or coronary arteries, as compared to others, were older (p= 0.003) and had higher levels of CRP, Il-6, and S100B. In each case, the differences were statistically significant. Conclusions The concentration of Il-6 and S100B on the first day of stroke are significant for both the neurological status and the functional status in the acute period of the disease. Increased CRP and leukocyte count are associated with a worse prognosis regarding the course of acute stroke. The expression of pro-inflammatory agents and markers of blood-brain barrier damage in the acute phase of stroke is more prominent in patients with symptomatic atherosclerosis than in patients with no clinical features of atherosclerosis.

The blood–brain barrier is the structure (BBB), which isolates the central nervous system from the external environmental. During a stroke, the BBB gets damaged, which is accompanied by changes in the concentrations and distributions of claudin-5, occludin, ZO-1, and other building blocks of the BBB. The aim of this study was to assess the concentrations of selected components of the BBB—occludin, claudin-5, and zonulin (ZO-1)—and to define a potential relationship between the concentrations of these three substances and the type of stroke, the location and extent of the infarct focus, the neurological/functional status in the acute phase of the disease, and the patient’s clinical profile. Methods: In this prospective study, we qualified patients with first-in-life stroke. All patients were analyzed according to: the presence of comorbidities, type of stroke (OCSP), treatment type in the first day of hospitalization, hemorrhagic transformation of infarct focus (ECASS), neurological status on the first day of stroke (NIHSS), functional status (mRS) on the ninth day of disease. In all patients, the plasma concentrations of claudin-5, occludin, and ZO-1 on the first day of stroke were examined and next, the mean concentrations were analyzed and compared between subgroups created on the basis of demographical and clinical features. Results: The mean concentration of occludin was significantly higher in patients with partial anterior cerebral infarct (PACI) compared to patients with posterior cerebral infarct (POCI; 1.03 vs. 0.66 ng/mL; p = 0.009) and in patients with location of ischemic stroke in the carotid artery supply compared with in the vertebrobasilar supply (respectively: 1.036 vs. 0.660 ng/mL; p = 0.009). The mean concentration of claudin 5 was significantly higher in patients with PACI compared to patients with POCI (0.37 vs. 0.21 ng/mL; p = 0.011) and in patients with location of ischemic stroke in the carotid artery supply in comparison with vertebrobasilar supply (respectively: 0.373 vs. 0.249 ng/mL; p = 0.011). The differences in mean occludin and claudin 5 concentrations between female and male were statistically not significant, similarly between patients < 65 years and older. A significantly higher mean concentration of zonulin was observed in patients > 65 years of age compared to younger patients (0.59 vs. 0.48 ng/mL; p = 0.010) and in patients with arterial hypertension compared to patients without the disease (0.63 ng/mL vs. 0.26 ng/mL; p = 0.026). There were no statistically significant relationships between the concentration of occludin, claudin 5, and zonulin and the neurological status according to the NIHSS on the first day of stroke. Conclusions: The location of stroke in the anterior part of the brain’s blood supply is associated with high blood levels of occludin and claudin 5 in the acute phase of stroke. The blood concentration of occludin is significantly lower in lacunar stroke comparing to this in non-lacunar stroke. Old age and arterial hypertension correlate positively with the concentration of zonulin 1 in acute stroke. There is no relationship between the blood levels of occludin, claudin 5, and zonulin 1 on the first day of stroke and the neurological and functional status in the acute phase of the disease.

Background: An increase in the troponin I (TnI) level is a marker of myocardial damage in acute coronary syndromes (ACS) and other conditions. According to the latest reports, an increase in the concentration of TnI in the acute phase of stroke relates to 1-34% of patients. The aim of this study was to evaluate the prevalence of elevated TnI concentration in patients with acute first-ever stroke and to examine its significance for the prediction of post-stroke disability degree and death within 30 days of stroke. An additional aim of the study was to compare the anatomic location of stroke in patients with normal and elevated TnI concentrations on the 1st day of stroke. Methods: Patients (M/F: 609/459; mean age 72 ± 11) with stroke numbering 1,068 were included in the prospective study. Their neurological deficit (National Institutes of Health Stroke Scale), TnI concentration (normal range ≤0.014 ng/ml), creatine kinase and ECG were examined on the 1st day of stroke. A follow-up and ECG were performed one day later in patients with abnormal TnI. The anatomical location of stroke (the right and left hemispheres and the brain stem) was compared in patients with normal and elevated TnI concentrations on the first day of stroke. The patients' functioning status was assessed using the by modified Rankin Scale (mRS) on the 30th day, and mortality was assessed within 30 days. The analysis was performed using a single and multi-factorial method of non-linear estimation for logistic regression in order to identify the independent factors for post-stroke disability at 4-6 points on the mRS on the 30th day following the onset and for death within 30 days of stroke in relation to the entire study group. The relative risk of a 4-6 point scoring on the mRS and of death among patients with abnormal TnI concentrations was also assessed. Results: Abnormal TnI concentration during stroke was observed in 9.73% of patients. The functioning status (mRS) of patients with elevated TnI was significantly worse 30 days post stroke as compared to patients with normal TnI concentration. Stroke was significantly more frequent in the right-hemisphere in patients with elevated TnI and no ischaemic changes in the ECG. For patients with ACS Tn+ during stroke, the mortality within 30 days after stroke was significantly more frequent than for patients without ACS Tn+. The abnormal TnI level neurological status on the 1st day of stroke and age were independent mortality factors within 30 days following stroke. Elevated TnI concentration, hypertension and neurological status on the 1st day of stroke were independent factors for post-stroke disability. Conclusions: Elevated TnI concentration occurs in 1/10 of patients with acute ischaemic stroke. It is connected with an unfavourable course of stroke leading to a significant disability and less independence in their everyday functioning. The right hemisphere is the most common site of stroke accompanied by elevated concentration of troponin in patients with no ischaemic changes in the electrocardiogram. Troponin-positive acute coronary syndrome in the period of acute stroke increases mortality within one month. Among patients with an abnormal troponin concentration in the acute phase of stroke, poor outcome is attributed to stroke severity on admission.

(1) Background: To report and analyze the presence of residual symptoms after SARS-CoV-2 infection among Polish patients with multiple sclerosis (MS) treated with different disease-modifying therapies (DMTs). (2) Methods: The study included 426 individuals with MS treated with DMTs and confirmed SARS-CoV-2 infection from 12 Polish MS centers. The data were collected through to 31 May 2021. The information included demographics, specific MS characteristics, course of SARS-CoV-2 infection, and residual (general and neurological) symptoms lasting more than four and 12 weeks after the initial infection. The results were obtained using maximum likelihood estimates for odds ratio and logistic regression. (3) Results: A total of 44.84% patients with MS reported symptoms lasting between four and 12 weeks after the initial infection; 24.41% people had symptoms that resolved up to 12 weeks, and 20.42% patients had symptoms that lasted over 12 weeks. The most common symptoms were: fatigue, disturbance of concentration, attention, and memory, cognitive complaints, and headache. None of the DMTs were predisposed to the development of residual symptoms after the initial infection. A total of 11.97% of patients had relapse three months prior or after SARS-CoV-2 infection. (4) Conclusion: Almost half of individuals with MS treated with different DMTs had residual symptoms after SARS-CoV-2 infection. None of the DMTs raised the probability of developing post-acute COVID symptoms.