Monocyte chemotactic protein-1 as a potential biomarker for early anti-thrombotic therapy after ischemic stroke

• Published in: International journal of molecular sciences 2012-07, Vol.13 (7), p.8670-8678
• Main Authors: Worthmann, Hans, Dengler, Reinhard, Schumacher, Helmut, Schwartz, Andreas, Eisert, Wolfgang G, Lichtinghagen, Ralf, Weissenborn, Karin
• Format: Article
• Language: English
• Subjects: acetylsalicylic acid (ASA); Adult; Aged; Aged, 80 and over; antithrombotic therapy; Aspirin; Aspirin - administration & dosage; Biomarkers; Biomarkers - blood; Body mass index; Brain Ischemia - blood; Brain Ischemia - drug therapy; Chemokine CCL2 - blood; dipyridamole; Dipyridamole - administration & dosage; Drug Therapy, Combination; Female; Follow-Up Studies; Humans; Ischemia; ischemic stroke; Leukocytes; Male; Middle Aged; monocyte chemoattractant protein-1 (MCP-1); neuroprotection; Platelet Aggregation Inhibitors - administration & dosage; Proteins; Stroke; Stroke - blood; Stroke - drug therapy; Time Factors; Traumatic brain injury
• ISSN: 1422-0067; 1661-6596; 1422-0067
• DOI: 10.3390/ijms13078670

Inflammation following ischemic brain injury is correlated with adverse outcome. Preclinical studies indicate that treatment with acetylsalicylic acid + extended-release dipyridamole (ASA + ER-DP) has anti-inflammatory and thereby neuroprotective effects by inhibition of monocyte chemotactic protein-1 (MCP-1) expression. We hypothesized that early treatment with ASA + ER-DP will reduce levels of MCP-1 also in patients with ischemic stroke. The EARLY trial randomized patients with ischemic stroke or TIA to either ASA + ER-DP treatment or ASA monotherapy within 24 h following the event. After 7 days, all patients were treated for up to 90 days with ASA + ER-DP. MCP-1 was determined from blood samples taken from 425 patients on admission and day 8. The change in MCP-1 from admission to day 8 did not differ between patients treated with ASA + ER-DP and ASA monotherapy (p > 0.05). Comparisons within MCP-1 baseline quartiles indicated that patients in the highest quartile (>217-973 pg/mL) showed improved outcome at 90 days if treated with ASA + ER-DP in comparison to treatment with ASA alone (p = 0.004). Our data does not provide any evidence that treatment with ASA + ER-DP lowers MCP-1 in acute stroke patients. However, MCP-1 may be a useful biomarker for deciding on early stroke therapy, as patients with high MCP-1 at baseline appear to benefit from early treatment with ASA + ER-DP.