[논문]Serum erythropoietin and outcome after ischaemic stroke: a prospective study

Å; berg, N David; Stanne, Tara M; Jood, Katarina; Schiö; ler, Linus; Blomstrand, Christian; Andreasson, Ulf; Blennow, Kaj; Zetterberg, Henrik; Isgaard, Jö; rgen; Jern, Christina; Svensson, Johan

doi:10.1136/bmjopen-2015-009827

Serum erythropoietin and outcome after ischaemic stroke: a prospective study 원문보기

BMJ open, v.6 no.2, 2016년, pp.e009827 -

Åberg, N David (Department of Internal Medicine , Institute of Medicine, Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden) , Stanne, Tara M (Department of Medical and Clinical Genetics , Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden) , Jood, Katarina (Department for Clinical Neuroscience and Rehabilitation , Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden) , Schiöler, Linus (Department of Occupational and Environmental Medicine , Institute of Medicine, Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden) , Blomstrand, Christian (Center of Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden) , Andreasson, Ulf (Department of Psychiatry and Neurochemistry , Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of) , Blennow, Kaj , Zetterberg, Henrik , Isgaard, Jörgen , Jern, Christina , Svensson, Johan

Abstract ▼ AI-Helper

ObjectivesErythropoietin (EPO), which is inversely associated with blood haemoglobin (Hb), exerts neuroprotective effects in experimental ischaemic stroke (IS). However, clinical treatment trials have so far been negative. Here, in patients with IS, we analysed whether serum EPO is associated with (1) initial stroke severity, (2) recovery and (3) functional outcome.DesignProspective. Controls available at baseline.SettingA Swedish hospital-initiated study with outpatient follow-up after 3 months.ParticipantsPatients (n=600; 64% males, mean age 56 years, controls n=600) were included from the Sahlgrenska Academy Study on IS (SAHLSIS).Primary and secondary outcome measuresIn addition to EPO and Hb, initial stroke severity was assessed by the Scandinavian Stroke Scale (SSS) and compared with SSS after 3 months (follow-up) as a measure of recovery. Functional outcome was evaluated using the modified Rankin Scale (mRS) at follow-up. Serum EPO and SSS were divided into quintiles in the multivariate regression analyses.ResultsSerum EPO was 21% and 31% higher than in controls at the acute phase of IS and follow-up, respectively. In patients, acute serum EPO was 19.5% higher in severe versus mild IS. The highest acute EPO quintile adjusted for sex, age and Hb was associated with worse stroke severity quintile (OR 1.70, 95% CI 1.00 to 2.87), better stroke recovery quintile (OR 1.93, CI 1.09 to 3.41) and unfavourable mRS 3–6 (OR 2.59, CI 1.15 to 5.80). However, the fourth quintile of EPO increase (from acute to follow-up) was associated with favourable mRS 0–2 (OR 3.42, CI 1.46 to 8.03). Only the last association withstood full adjustment.ConclusionsThe crude associations between EPO and worse stroke severity and outcome lost significance after multivariate modelling. However, in patients in whom EPO increased, the association with favourable outcome remained after adjustment for multiple covariates.

주제어

참고문헌 (20)

1 Dame C , Juul SE , Christensen RD The biology of erythropoietin in the central nervous system and its neurotrophic and neuroprotective potential . Biol Neonate 2001 ; 79 : 228 – 35 . doi:47097 11275657

상세보기
2 Wang L , Zhang Z , Wang Y Treatment of stroke with erythropoietin enhances neurogenesis and angiogenesis and improves neurological function in rats . Stroke 2004 ; 35 : 1732 – 7 . 10.1161/01.STR.0000132196.49028.a4 15178821

상세보기
3 Beguin Y , Clemons GK , Pootrakul P Quantitative assessment of erythropoiesis and functional classification of anemia based on measurements of serum transferrin receptor and erythropoietin . Blood 1993 ; 81 : 1067 – 76 . 8427988

상세보기
4 Sirén AL , Knerlich F , Poser W Erythropoietin and erythropoietin receptor in human ischemic/hypoxic brain . Acta Neuropathol (Berl) 2001 ; 101 : 271 – 6 . 11307627
5 Ehrenreich H , Hasselblatt M , Dembowski C Erythropoietin therapy for acute stroke is both safe and beneficial . Mol Med 2002 ; 8 : 495 – 505 . 12435860
6 Jerndal M , Forsberg K , Sena ES A systematic review and meta-analysis of erythropoietin in experimental stroke . J Cereb Blood Flow Metab 2010 ; 30 : 961 – 8 . 10.1038/jcbfm.2009.267 20040929

상세보기
7 Sargin D , Friedrichs H , El-Kordi A Erythropoietin as neuroprotective and neuroregenerative treatment strategy: comprehensive overview of 12 years of preclinical and clinical research . Best Pract Res Clin Anaesthesiol 2010 ; 24 : 573 – 94 . 21619868

상세보기
8 Ehrenreich H , Weissenborn K , Prange H Recombinant human erythropoietin in the treatment of acute ischemic stroke . Stroke 2009 ; 40 : e647 – 56 . 10.1161/STROKEAHA.109.564872 19834012

상세보기
9 Cramer SC , Hill MD , REGENESIS-LED Investigators . Human choriogonadotropin and epoetin alfa in acute ischemic stroke patients (REGENESIS-LED trial) . Int J Stroke 2014 ; 9 : 321 – 7 . 10.1111/ijs.12260 24588854

상세보기
10 Worthmann H , Martens-Lobenhoffer J , Joumaah M Asymmetric dimethylarginine in response to recombinant tissue-type plasminogen activator and erythropoietin in acute stroke . Stroke 2013 ; 44 : 2128 – 33 . 10.1161/STROKEAHA.113.001145 23788583

상세보기
11 Tanne D , Molshatzki N , Merzeliak O Anemia status, hemoglobin concentration and outcome after acute stroke: a cohort study . BMC Neurol 2010 ; 10 : 22 10.1186/1471-2377-10-22 20380729

상세보기
12 Weidemann A , Kerdiles YM , Knaup KX The glial cell response is an essential component of hypoxia-induced erythropoiesis in mice . J Clin Invest 2009 ; 119 : 3373 – 83 . 10.1172/JCI39378 19809162

상세보기
13 Jood K , Ladenvall C , Rosengren A Family history in ischemic stroke before 70 years of age: the Sahlgrenska Academy Study on Ischemic Stroke . Stroke 2005 ; 36 : 1383 – 7 . 10.1161/01.STR.0000169944.46025.09 15933254

상세보기
14 Aberg D , Jood K , Blomstrand C Serum IGF-I levels correlate to improvement of functional outcome after ischemic stroke . J Clin Endocrinol Metab 2011 ; 96 : E1055 – 64 . 10.1210/jc.2010-2802 21508132

상세보기
15 Åberg ND , Olsson S , Åberg D Genetic variation at the IGF1 locus shows association with post-stroke outcome and to circulating IGF1 . Eur J Endocrinol 2013 ; 169 : 759 – 65 . 10.1530/EJE-13-0486 24005314

상세보기
16 Jood K , Ladenvall P , Tjärnlund-Wolf A Fibrinolytic gene polymorphism and ischemic stroke . Stroke 2005 ; 36 : 2077 – 81 . 10.1161/01.STR.0000183617.54752.69 16179568

상세보기
17 Pedersen ED , Waje-Andreassen U , Vedeler CA Systemic complement activation following human acute ischaemic stroke . Clin Exp Immunol 2004 ; 137 : 117 – 22 . 10.1111/j.1365-2249.2004.02489.x 15196251

상세보기
18 Hallström B , Jönsson AC , Nerbrand C Lund Stroke Register: hospitalization pattern and yield of different screening methods for first-ever stroke . Acta Neurol Scand 2007 ; 115 : 49 – 54 . 10.1111/j.1600-0404.2006.00738.x 17156265

상세보기
19 Kellert L , Martin E , Sykora M Cerebral oxygen transport failure? Decreasing hemoglobin and hematocrit levels after ischemic stroke predict poor outcome and mortality: STroke: RelevAnt Impact of hemoGlobin, Hematocrit and Transfusion (STRAIGHT)—an observational study . Stroke 2011 ; 42 : 2832 – 7 . 10.1161/STROKEAHA.110.606665 21852622

상세보기
20 Spiropoulos A , Goussetis E , Margeli A Effect of inflammation induced by prolonged exercise on circulating erythroid progenitors and markers of erythropoiesis . Clin Chem Lab Med 2010 ; 48 : 199 – 203 . 10.1515/CCLM.2010.034 20001441

상세보기

내보내기 구분	파일저장 인쇄 메일전송
구성항목	기본정보 상세정보 관리번호, 논문명, 저널/프로시딩명, 저자 , 발행년, 권, 호, 시작페이지, 끝페이지, 발행기관 관리번호, 논문명, 대등논문명, 저자 , 저널/프로시딩명, 발행기관, 발행년, 발행언어, 권, 호, 시작페이지, 끝페이지, ISBN, ISSN, 주제분야, 키워드, 초록(한글), 초록(영문), 저자(소속기관)
저장형식	Text(ASCII format) Excel format RefWorks Direct Export RIS format (for Reference Manager, ProCite, EndNote), Scholar's Aids, Mendeley
메일정보	받는사람 (필수) @ 보내는사람 (선택) @ 제목 내용 KISTI 검색결과 이메일 서비스
안내	총 건의 자료가 검색되었습니다. 다운받으실 자료의 인덱스를 입력하세요. (1-10,000) 검색결과의 순서대로 최대 10,000건 까지 다운로드가 가능합니다. 데이타가 많을 경우 속도가 느려질 수 있습니다.(최대 2~3분 소요) 다운로드 파일은 UTF-8 형태로 저장됩니다. 파일의 내용이 제대로 보이지 않을실 때는 웹브라우저 상단의 보기 -> 인코딩 -> 자동선택 여부를 확인하십시오. ~ Text(ASCII format) Excel format

연합인증

Serum erythropoietin and outcome after ischaemic stroke: a prospective study 원문보기

Abstract ▼ AI-Helper

주제어

참고문헌 (20)

이 논문을 인용한 문헌

관련 콘텐츠

원문 보기

원문 URL 링크

오픈액세스(OA) 유형

이 논문과 함께 이용한 콘텐츠

AI-Helper ※ AI-Helper는 오픈소스 모델을 사용합니다.

선택된 텍스트