Serum Levels Of Macrophage Migration Inhibitory Factor And S-100B Proteins In Patients With Acute Cerebral Infarction And Their Correlation With Clinical Data

Objective: Cerebrovascular disease (Cerebrovascular disease, CVD) isone of the major diseases of serious harm to human life and health andquality of life, it has become the world's second largest fatal disease, whileChina is one of the countries and regions with the highest incidence rates.Cerebrovascular disease is characteristic of high prevalence, high mortalityand high morbidity. Cerebral infarction (Cerebral infarction, CI) is the mostimportant type of cerebrovascular disease, and occupies about70%of allcerebrovascular diseases. In recent years, studies have shown that theinflammatory response mechanisms play an important role in thepathogenesis and pathophysiology of cerebral infarction. Research in thisregard provides a theoretical basis for diagnosis, treatment and prognosis ofcerebral infarction. Macrophage migration inhibitory factor (MIF),which is aproinflammatory cytokine, is contribute to the pathophysiology of cerebralinfarction and plays an important role in immunization and inflammatory ofcerebral infarction. MIF not only inhibits the migration of macrophages,gatheres its local inflammatory response, enhances phagocytic function ofmacrophage, but also induces macrophage to secrete various cytokines,which may participate in and promote atherosclerosis. S-100B protein is acalcium binding protein, mainly in astrocytes and Schwann cells, plays animportant role in the growth and repair process in the central nervous system,S-100B is a marker of nerve injury. In this study, serum macrophagemigration inhibitory factor and S-100B protein levels in patients with acutecerebral infarction patients and normal control objects were analyzed toevaluate their value in clinical diagnosis of cerebral infarction and theassociation with the severity of neurological deficiency, therefore determine the predictive value of MIF and S-100B on the severity and prognosis ofcerebral infarction.Methods: Subjects: All cases are patients with acute cerebral infarctiontreated in Department of neurology and health people for a normal physicalexamination in health examination center, which collected from October2011to March2012in Second Hospital of Hebei Medical University, andwere divided into cerebral infarction group and normal control group.Cerebral infarction group:60cases of patients with acute cerebral infarctionwithin72hours of onset. Among them,50cases of male and10cases offemale, age between39to78years old, average age (58.95±9.826) years ofage. All cases:(1) were completely consistent with cerebrovascular diseasediagnostic criteria developed in the Fourth National CerebrovascularDiseases Conference in1995;(2) suffered from cerebral infarctionconfirmed by brain CT or MRI;(3) blood specimen were collectedwithin72hours of onset. And to exclude:(1) With severe secondaryinfection, severe inflammation disease, accompanied by multiple organfailure, and steroid hormone drugs, immunosuppressive agents or otheranti-inflammatory drug therapy;(2) Cerebral infarction patients caused bythe blood system disease;(3) All patients were excluded from the recentmajor surgery, history of trauma, tumors and autoimmune diseases. Normalcontrol group: healthy people for a normal physical examination in healthexamination center in the same period, including19people. Among them,12men and7women, aged between38and75years old, mean age(54.16±11.495). cerebral infarction group was divided into mild, moderate orsevere cerebral infarction subgroups according to NIHSS score (≤5,6to13,≥14points respectively). Blood serum was collected and MIF and theS-100B protein levels were detected using a double antibody sandwichELISA. Meanwhile, the patient's admission and discharge NIHSS scoreswere recorded.Statistical analysis was performed with the professional statistical softwareSPSS19.0. Between the cerebral infarction group and normal control group, the Mann-Whitney U test was used to compare the results of the MIF andS-100B protein levels, and Spearman's correlation coefficient was performedto determine the correlation of the MIF and S-100B levelwith the clinicaldata. ROC curve was used to analyze the prompt significance of MIF andS-100B protein levels to patients with acute cerebral infarction. P<0.05wasconsidered significant for all statistical analyses.Results:(1) Between the cerebral infarction group and control group, difference wasnot significant in sex (p=0.122, P>0.05), and age (p=0.079, P>0.05).(2) The serum MIF was significantly decreased in the cerebral infarctiongroup (115.7±100.9) pg/ml compared to normal control group (217.5±121.4)pg/ml (P=0.00019, P<0.05). Serum S-100B level had no significantdifference between the cerebral infarction group (0.326±0.139) ng/ml andnormal control group (.328±0.130) ng/ml. MIF and S-100B levels in mild,moderate or severe cerebral infarction subgroups showed no significantdifference. But in mild, medium, severe infarction groups, serum MIF levelswere all significantly higher than the normal control group.(3) In cerebral infarction group, we did not find significant correlationbetween serum levels of MIF/S-100B and NIHSS scores recorded whenhospitalized and discharged; but the tendency was found in MIF level todecrease progressively with the severity of cerebral infarction.(4) the serumlevel of MIF in the area under the ROC curve: AUC=0.785, P=0.00019,P<0.05. MIF values for92.4pg/ml is optimal critical point, sensitivity=0.550,specificity=0.947. Youden index=0.497. Serum S-100B level in the areaunder the ROC curve: AUC=0.508, P=0.913, P>0.05, test critical value ofS-100B level=0.231ng/ml, sensitivity=0.267, specificity=0.895. Youdenindex=0.161.Conclusion:(1) In patients with acute cerebral infarction compared with normal objects,serum MIF levels were significantly decreased. MIF involved in the processof cerebral infarction pathology. But no significant changes in serum S-100B protein level was found;(2) No significant correlation between serum MIF and S-100B protein levelsand disease severity in patients with acute cerebral infarction; but thetendency was found in MIF level to decrease progressively with the severityof cerebral infarction, so the MIF level can reflect the severity of cerebralinfarction to some extent.(3) Testing serum MIF levels in acute cerebral infarction has a promptsignificance, while serum S-100B protein levels of low prompt significancein evaluating acute cerebral infarction.