AUTHOR=Chen Zhuo , Cao Tianli , Zhong Xingju , Wu Yong , Fu Wei , Fan Chaoli , Jiang Yu , Zhou Qi , Peng Jie , Liao Jieyu , You Zhike , Yi Xin , Tan Jingyu 

TITLE=Association between serum netrin-1 levels and early neurological deterioration after acute ischemic stroke

JOURNAL=Frontiers in Neurology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.953557

DOI=10.3389/fneur.2022.953557

ISSN=1664-2295

ABSTRACT=<sec><title>Background and purposes</title><p>Experimental studies demonstrated that netrin-1 (NT-1) has anti-inflammatory, tissue regeneration, and immune modulation properties. We aimed to discern the utility of NT-1 as a biomarker for assessing the risk of early neurological deterioration (END) after ischemic stroke.</p></sec><sec><title>Methods</title><p>This was a prospective study enrolling ischemic stroke patients with symptoms onset &lt;24 h. Serum NT-1 concentrations were measured at admission. The National Institutes of Health Stroke Scale increased by ≥2 points and ≥4 points during the first 72 h after admission and was defined as END2 and END4, respectively.</p></sec><sec><title>Results</title><p>The study included 268 patients (146 men and 122 women) with a mean age of 63.0 ± 9.6 years. The median NT-1 concentrations were 466.4 pg/ml (interquartile range, 341.4–589.2 pg/ml). During the initial 72 h after admission, END2 was found in 83 (31.0%) patients, and END4 was observed in 48 (17.9%) subjects. After adjusted for potential confounders, multivariate analysis indicated that decreased NT-1 levels is an independent predictor for END2 [odds ratio (<italic>OR</italic>) 0.62, 95% confidence interval (<italic>CI</italic>) 0.46–0.84, <italic>p</italic> &lt; 0.001) and END4 (<italic>OR</italic> 0.53, 95% <italic>CI</italic> 0.36–0.76, <italic>p</italic> &lt; 0.001). Similar results were found when the NT-1 levels were analyzed as a categorical variable. Furthermore, restricted cubic spline analysis showed a linear association between NT-1 concentrations and the risk of END (END2, <italic>p</italic> = 0.006 for linearity; END4, <italic>p</italic> &lt; 0.001 for linearity).</p></sec><sec><title>Conclusions</title><p>Our results suggest that decreased NT-1 levels were significantly associated with a higher risk of END after ischemic stroke.</p></sec>