4-2009

.: Дата публікації 2010-01-17 :: Переглядів: 4 :: :.

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The state of a stress-realizing immune-neuro-endocrine system in patients with cerebral ischemic stroke
V.O. MONASTYRSKIY, V.O. MALAKHOV

Objective – to study the functional state of stress-realizing immune-neuro-endocrine system in acute cerebral
ischemic stroke by definition of trigger proinflammatory cytokines levels – interleukin-1β (IL-1β) and tumor necrosis factor α (TNF-α), stressor hormones – ACTH and cortisol and neuropeptide with stress-limiting properties – β-endorphin.
Methods and subjects. 68 patients with carotid ischemic stroke at the age of 40 – 70 years were examined. The degree of neurologic deficiency in stroke patients has been examined with NIHSS (National Institutes of Health Stroke Scale). Plasma levels of IL-1β, TNF-α, ACTH, cortisol and β-endorphin were studied in patients on the 1-st day and the 10-th day of ischemic stroke by immune-enzyme analysis.
Results. High levels of proinflammatory cytokines, ACTH, cortisol and b-endorphin are revealed on the 1st day
of ischemic stroke that testifies activation the stress-realizing hypothalamic-pituitary-adrenal system and the stress-limiting system of endogenous opioid peptides. These values decreased on the 10th day of stroke. The relationship between these mediators and the degree of neurological deficiency has been established.
Conclusions. An acute ischemic stroke is accompanied by the stress-reaction of immune-neuro-endocrine system, that realizes through hypothalamic-pituitary-adrenal axis. Proinflammatory cytokines – IL-1β and TNF-α – are triggers of the stress-reply. The activation of stress-limiting endogenous opioid system takes place simultaneously with the stress-realizing mechanisms. Exposed relationships between IL-1β, TNF-α, ACTH, cortisol, β-endorphin and the degree of neurological deficiency testifies the influence of those mediators on current and outcomes of stroke.