The incidence of small vessel-type (lacunar) ischemic strokes is greater in African-Americans compared to whites. The chronic inflammatory changes that result from lacunar stroke are poorly understood. To elucidate these changes, we measured serum inflammatory and thrombotic biomarkers in African-Americans at least 6 weeks post-stroke compared to control individuals. Cases were African-Americans with lacunar stroke (n = 30), and controls were age-matched African-Americans with no history of stroke or other major neurologic disease (n = 37). Blood was obtained > 6 weeks post-stroke and was analyzed for inflammatory biomarkers. Freshly isolated peripheral blood mononuclear cells were stimulated with lipopolysaccharide (LPS) to assess immune responsiveness in a subset of cases (n = 5) and controls (n = 4). After adjustment for covariates, the pro-inflammatory biomarkers, soluble vascular cadherin adhesion molecule-1 (sVCAM-1) and thrombin anti-thrombin (TAT), were independently associated with lacunar stroke. Immune responsiveness to LPS challenge was abnormal in cases compared to controls. African-Americans with lacunar stroke had elevated blood levels of VCAM-1 and TAT and an abnormal response to acute immune challenge > 6 weeks post-stroke, suggesting a chronically compromised systemic inflammatory response.
Digital Object Identifier (DOI)
This study was funded by American Stroke Association/Bugher Foundation Center for Stroke Prevention Research.
Brown, Candice M.; Bushnell, Cheryl D.; Samsa, Gregory P.; Goldstein, Larry B.; and Colton, Carol A., "Chronic Systemic Immune Dysfunction in African-Americans with Small Vessel-Type Ischemic Stroke" (2015). Neurology Faculty Publications. 44.