The Prognostic Determinant of Interleukin-10 in Patients with Acute Ischemic Stroke: An Analysis from the Perspective of Disease Management
Sun Wen, Shuhui Wang, Shanji Nan
Abstract
Background. In patients with ischemic stroke, the role of anti-inflammatory cytokine Interleukin-10 (IL-10) in predicting risk and outcomes is not very clear. This study is aimed at prospectively assessing the prognostic determinant value of IL-10 in patients with acute ischemic stroke in a cohort of Chinese people. Methods. In a prospective cohort study, consecutive first-ever patients with acute ischemic stroke admitted to our hospital were included from October 2019 to October 2020. The serum level of IL-10 was measured at baseline. A structured follow-up telephone interview was performed on day 90 after admission. Logistic regression analyses were used to assess the prognostic value of IL-10 to predict the poor functional outcome (defined as a modified Rankin Scale score of 3 to 6) and mortality. Results. The median age of the 236 enrolled patients was 65 years (interquartile range (IQR), 56-76), and 57.6% were male. There was a negative correlation between the National Institutes of Health Stroke Scale (NIHSS) score and IL-10 serum levels ( <a:math xmlns:a="http://www.w3.org/1998/Math/MathML" id="M1"> <a:mi>r</a:mi> <a:mtext> </a:mtext> <a:mfenced open="(" close=")"> <a:mrow> <a:mtext>Spearman</a:mtext> </a:mrow> </a:mfenced> <a:mo>=</a:mo> <a:mo>−</a:mo> <a:mn>0.221</a:mn> </a:math> , <e:math xmlns:e="http://www.w3.org/1998/Math/MathML" id="M2"> <e:mi>P</e:mi> <e:mo>=</e:mo> <e:mn>0.001</e:mn> </e:math> ). Patients with elevated IL-10 levels (> the highest <g:math xmlns:g="http://www.w3.org/1998/Math/MathML" id="M3"> <g:mtext>quartile</g:mtext> <g:mo>=</g:mo> <g:mn>5.24</g:mn> <g:mtext> </g:mtext> <g:mtext>pg</g:mtext> <g:mo>/</g:mo> <g:mtext>mL</g:mtext> </g:math> ; <i:math xmlns:i="http://www.w3.org/1998/Math/MathML" id="M4"> <i:mi>n</i:mi> <i:mo>=</i:mo> <i:mn>79</i:mn> </i:math> ) were at significantly lower risk of poor functional outcomes (odds ratio (OR), 0.35; 95% confidence interval (CI), 0.19 to 0.63; <k:math xmlns:k="http://www.w3.org/1998/Math/MathML" id="M5"> <k:mi>P</k:mi> <k:mo><</k:mo> <k:mn>0.001</k:mn> </k:math> ) and mortality ( <m:math xmlns:m="http://www.w3.org/1998/Math/MathML" id="M6"> <m:mtext>OR</m:mtext> <m:mo>=</m:mo> <m:mn>0.24</m:mn> </m:math> ; 95% <o:math xmlns:o="http://www.w3.org/1998/Math/MathML" id="M7"> <o:mtext>CI</o:mtext> <o:mo>=</o:mo> <o:mn>0.11</o:mn> </o:math> –0.52; <q:math xmlns:q="http://www.w3.org/1998/Math/MathML" id="M8"> <q:mi>P</q:mi> <q:mo><</q:mo> <q:mn>0.001</q:mn> </q:math> ) compared with patients with IL-10 levels in the lowest three quartiles. Conclusions. Reduced serum levels of IL-10 were independently associated with both the clinical severity at admission and a poor functional prognosis in ischemic stroke patients, suggesting that the anti-inflammatory cytokine IL-10 was an important prognostic determinant.