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ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #163245
Title: DECREASED LEVELS OF PLASMA VITAMIN C AND INCREASED CONCENTRATIONS OF INFLAMMATORY AND OXIDATIVE STRESS MARKERS AFTER STROKE

Author
item SANCHEZ-MOREN0, CONCEPCION - TUFTS UNIVERSITY
item DASHE, JOHN - TUFTS-NEMC
item SCOTT, TAMMY - TUFTS UNIVERSITY
item THALER, DAVID - TUFTS-NEMC
item FOLSTEIN, MARSHAL - TUFTS UNIVERSITY
item MARTIN, ANTONIO - TUFTS-HNRCA

Submitted to: Stroke
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/2/2003
Publication Date: 1/1/2004
Citation: SANCHEZ-MOREN0, C., DASHE, J., SCOTT, T., THALER, D., FOLSTEIN, M.F., MARTIN, A. DECREASED LEVELS OF PLASMA VITAMIN C AND INCREASED CONCENTRATIONS OF INFLAMMATORY AND OXIDATIVE STRESS MARKERS AFTER STROKE. STROKE. 2004;35:163-168.

Interpretive Summary: Stroke is the second leading cause of mortality worldwide. In addition, about one quarter of patients suffering a stroke are found to be demented three months later. Inflammatory response associated with stroke plays a critical role in the complex pathological changes that occur in response to stroke. Vitamin C has been shown to be very important for optimum function of the cardiovascular system. In this study, we evaluated whether antioxidant status is low in stroke patients. Further, we assessed the degree and characteristics of the inflammatory response following stroke and whether the sntioxidant status is associated with changes in oxidative stress and inflammation. We evaluated the nutritional status and measured plasma levels of vitamin C and vitamin E, and uric acid. In addition we measured: serum levels of various markers of inflammation including C-reactive protein, cytokines (TNF-alpha and IL-1-beta), adhesion molecule (ICAM-1), chemokine (MCP-1), prostaglandins (PGE2 and PGI2), and oxidative stress (8-isoprostanes) for 15 patients with stroke--within 2 to 4 days after the onset of stroke--and for 24 matched control subjects. The stroke patients had significantly lower plasma levels of vitamin C than did the control subjects. Among the stroke patients, concentrations of several markers of inflammation were significantly greater than control subjects. Oxidative stress (8-epiPGF2-alpha) was also elevated in stroke patients. Changes in antioxidant concentrations; elevated serum levels of inflammatory markers and oxidative stress among the stroke patients indicate that stroke is accompanied by a strong inflammatory response, and high levels of oxidative stress. This type of response appears to play a relevant role in the stroke patient's prognosis.

Technical Abstract: Inflammatory response is a critical component of the complex pathophysiological response to stroke. Vitamin C has been shown to have important roles in cell performance and vascular function. In this study, we compared the nutritional status and levels of inflammatory markers between stroke cases and controls and assessed which antioxidant was associated with levels of inflammatory markers and oxidative stress among cases and controls. We evaluated the nutritional status and measured plasma levels of vitamins C and E, uric acid, serum levels of C-reactive protein (CRP), the cytokines tumor necrosis factor-alpha and interleukin-1-beta, intercellular adhesion molecule-1 (ICAM-1) and chemokine monocyte chemoattractant protein-1 (MCP-1), prostaglandins PGE2 and PGI2, and 8-isoprostanes (8-epiPGF2-alpha) for 15 patients with ischemic stroke within 2 to 5 days after stroke onset and for 24 control subjects. Stroke patients had significantly lower plasma levels of vitamin C than did controls. Among stroke patients, CRP was significantly elevated, as were the ICAM-1, MCP-1, and 8-epiPGF2-alpha, but the prostaglandins PGE2 and PGI2 were significantly reduced. Interestingly, vitamin C concentration was significantly inversely correlated with the levels of CRP and 8-epiPGF2-alpha among stroke patients, and 8-epiPGF2-alpha was significantly associated with the levels of CRP. Uric acid was also elevated among stroke patients. Lower vitamin C concentration, higher serum levels of inflammatory (CRP, ICAM-1, MCP-1) and oxidative stress (8-epiPGF2-alpha) markers, and lower PGI2 and PGE2 concentrations among stroke patients indicate the presence of an inflammatory response associated with stroke.