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Significance of decreased serum interleukin-10 levels in the progression of cerebral infarction

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Abstract

Anti-inflammatory cytokine and its serological detection may have an important role in the process of cardiovascular and cerebrovascular diseases. We investigated whether serum interleukin-10 (IL-10) is associated with cerebral infarction or not in the general population. Identified comprehensive searching was performed covering PubMed, EMBASE, Web of Science, Cochrane Library, CISCOM, CINAHL, Google Scholar, China BioMedicine, and China National Knowledge Infrastructure databases. Two reviewers extracted data and assessed studies independently. Information was extracted separately and classed into Asians and Caucasians. Summary standardized mean differences (SMDs) with 95 % confidence intervals (CI) were used with the utilization of Z test. Nine studies ranged from 2003 to 2014 were collected for meta-analysis. Results identified a negative association between serum IL-10 levels and cerebral infarction (SMD = 1.80, 95 % CI 0.79–2.81, P < 0.001). Country-subgroup analysis showed that low IL-10 level may be the main risk factor for cerebral infarction in India (SMD = 1.44, 95 % CI 1.13–1.75, P < 0.001) and Croatia (SMD = 2.96, 95 % CI 2.48–3.44, P < 0.001). In the ethnicity-stratified subgroup analysis, serum IL-10 levels were negatively correlated with cerebral infarction in Asians (SMD = 2.52, 95 % CI 0.47–4.57, P = 0.016), while not in Caucasians (P > 0.05). The lower serum IL-10 concentration was significantly associated with an increased likelihood of cerebral infarction in this meta-analysis. More prospective studies should be conducted to provide stronger evidence justifying the use of IL-10 as new biomarker to identify a predisposition toward cerebral infarction.

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References

  1. Attwell D, Buchan AM, Charpak S, Lauritzen M, Macvicar BA, Newman EA. Glial and neuronal control of brain blood flow. Nature. 2010;468:232–43.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Doehner W, von Haehling S, Suhr J, et al. Elevated plasma levels of neuropeptide proenkephalin a predict mortality and functional outcome in ischemic stroke. J Am Coll Cardiol. 2012;60:346–54.

    Article  CAS  PubMed  Google Scholar 

  3. Jeon YJ, Kim OJ, Kim SY, et al. Association of the miR-146a, miR-149, miR-196a2, and miR-499 polymorphisms with ischemic stroke and silent brain infarction risk. Arterioscler Thromb Vasc Biol. 2013;33:420–30.

    Article  CAS  PubMed  Google Scholar 

  4. Rutten-Jacobs LC, Arntz RM, Maaijwee NA, et al. Long-term mortality after stroke among adults aged 18 to 50 years. JAMA. 2013;309:1136–44.

    Article  CAS  PubMed  Google Scholar 

  5. Kim OJ, Hong SH, Jeon YJ, et al. Gene-environment interactions between methylenetetrahydrofolate reductase (MTHFR) 677C > T and metabolic syndrome for the prevalence of ischemic stroke in Koreans. Neurosci Lett. 2013;533:11–6.

    Article  CAS  PubMed  Google Scholar 

  6. Kwan J, Horsfield G, Bryant T, et al. IL-6 is a predictive biomarker for stroke associated infection and future mortality in the elderly after an ischemic stroke. Exp Gerontol. 2013;48:960–5.

    Article  CAS  PubMed  Google Scholar 

  7. Pinto A, Tuttolomondo A, Casuccio A, et al. Immuno-inflammatory predictors of stroke at follow-up in patients with chronic non-valvular atrial fibrillation (NVAF). Clin Sci (Lond). 2009;116:781–9.

    Article  CAS  Google Scholar 

  8. Tuttolomondo A, Di Raimondo D, Forte GI, et al. Single nucleotide polymorphisms (SNPs) of pro-inflammatory/anti-inflammatory and thrombotic/fibrinolytic genes in patients with acute ischemic stroke in relation to TOAST subtype. Cytokine. 2012;58:398–405.

    Article  CAS  PubMed  Google Scholar 

  9. Tuttolomondo A, Di Raimondo D, Pecoraro R, et al. Inflammation in ischemic stroke subtypes. Curr Pharm Des. 2012;18:4289–310.

    Article  CAS  PubMed  Google Scholar 

  10. Jin R, Liu L, Zhang S, et al. Role of inflammation and its mediators in acute ischemic stroke. J Cardiovasc Transl Res. 2013;6:834–51.

    Article  PubMed  Google Scholar 

  11. Whiteley W, Wardlaw J, Dennis M, et al. The use of blood biomarkers to predict poor outcome after acute transient ischemic attack or ischemic stroke. Stroke. 2012;43:86–91.

    Article  CAS  PubMed  Google Scholar 

  12. Li J, Zhu H, Liu Y, et al. Human mesenchymal stem cell transplantation protects against cerebral ischemic injury and upregulates interleukin-10 expression in Macaca fascicularis. Brain Res. 2010;1334:65–72.

    Article  CAS  PubMed  Google Scholar 

  13. Marousi S, Ellul J, Antonacopoulou A, Gogos C, Papathanasopoulos P, Karakantza M. Functional polymorphisms of interleukin 4 and interleukin 10 may predict evolution and functional outcome of an ischaemic stroke. Eur J Neurol. 2011;18:637–43.

    Article  CAS  PubMed  Google Scholar 

  14. Park HK, Kim DH, Yun DH, Ban JY. Association between IL10, IL10RA, and IL10RB SNPs and ischemic stroke with hypertension in Korean population. Mol Biol Rep. 2013;40:1785–90.

    Article  CAS  PubMed  Google Scholar 

  15. Commins S, Steinke JW, Borish L. The extended IL-10 superfamily: IL-10, IL-19, IL-20, IL-22, IL-24, IL-26, IL-28, and IL-29. J Allergy Clin Immunol. 2008;121:1108–11.

    Article  CAS  PubMed  Google Scholar 

  16. Mosser DM, Zhang X. Interleukin-10: new perspectives on an old cytokine. Immunol Rev. 2008;226:205–18.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Zimmerman MA, Reznikov LL, Raeburn CD, Selzman CH. Interleukin-10 attenuates the response to vascular injury. J Surg Res. 2004;121:206–13.

    Article  CAS  PubMed  Google Scholar 

  18. Xie G, Myint PK, Zaman MJ, et al. Relationship of serum interleukin-10 and its genetic variations with ischemic stroke in a Chinese general population. PLoS ONE. 2013;8:e74126.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Singh HV, Pandey A, Shrivastava AK, Raizada A, Singh SK, Singh N. Prognostic value of neuron specific enolase and IL-10 in ischemic stroke and its correlation with degree of neurological deficit. Clin Chim Acta. 2013;419:136–8.

    Article  CAS  PubMed  Google Scholar 

  20. Ooboshi H, Ibayashi S, Shichita T, et al. Postischemic gene transfer of interleukin-10 protects against both focal and global brain ischemia. Circulation. 2005;111:913–9.

    Article  CAS  PubMed  Google Scholar 

  21. Frijns CJ, Kappelle LJ. Inflammatory cell adhesion molecules in ischemic cerebrovascular disease. Stroke. 2002;33:2115–22.

    Article  CAS  PubMed  Google Scholar 

  22. de Waal Malefyt R, Abrams J, Bennett B, et al. Interleukin 10 (IL-10) inhibits cytokine synthesis by human monocytes: an autoregulatory role of IL-10 produced by monocytes. J Exp Med. 1991;174:1209–20.

    Article  Google Scholar 

  23. Fiorentino DF, Zlotnik A, Vieira P, et al. IL-10 acts on the antigen-presenting cell to inhibit cytokine production by Th1 cells. J Immunol. 1991;146:3444–51.

    CAS  PubMed  Google Scholar 

  24. Jin R, Yang G, Li G. Inflammatory mechanisms in ischemic stroke: role of inflammatory cells. J Leukoc Biol. 2010;87:779–89.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Iadecola C, Alexander M. Cerebral ischemia and inflammation. Curr Opin Neurol. 2001;14:89–94.

    Article  CAS  PubMed  Google Scholar 

  26. Jing LY, Jing LL, Liu M. Ischemic stroke neurological deficit of ischemic stroke is correlated to inflammatory factors. Chin Med Pharm. 2013;6:215–6.

    Google Scholar 

  27. Yang Y, Li XZ. ADPN plasma concentration of cerebral stroke is correlated to inflammatory factors. Chin J Behav Med Brain Sci. 2009;18:1010–2.

    CAS  Google Scholar 

  28. Licata G, Tuttolomondo A, Di Raimondo D, Corrao S, Di Sciacca R, Pinto A. Immuno-inflammatory activation in acute cardio-embolic strokes in comparison with other subtypes of ischaemic stroke. Thromb Haemost. 2009;101:929–37.

    CAS  PubMed  Google Scholar 

  29. Jackson D, White IR, Riley RD. Quantifying the impact of between-study heterogeneity in multivariate meta-analyses. Stat Med. 2012;31:3805–20.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Peters JL, Sutton AJ, Jones DR, Abrams KR, Rushton L. Comparison of two methods to detect publication bias in meta-analysis. JAMA. 2006;295:676–80.

    Article  CAS  PubMed  Google Scholar 

  31. Sterne JA, Egger M. Funnel plots for detecting bias in meta-analysis: guidelines on choice of axis. J Clin Epidemiol. 2001;54:1046–55.

    Article  CAS  PubMed  Google Scholar 

  32. Wikstrom EA, Naik S, Lodha N, Cauraugh JH. Balance capabilities after lateral ankle trauma and intervention: a meta-analysis. Med Sci Sports Exerc. 2009;41:1287–95.

    Article  PubMed  Google Scholar 

  33. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315:629–34.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Basic Kes V, Simundic AM, Nikolac N, Topic E, Demarin V. Pro-inflammatory and anti-inflammatory cytokines in acute ischemic stroke and their relation to early neurological deficit and stroke outcome. Clin Biochem. 2008;41:1330–4.

    Article  CAS  PubMed  Google Scholar 

  35. Chang LT, Yuen CM, Liou CW, et al. Link between interleukin-10 level and outcome after ischemic stroke. Neuroimmunomodulation. 2010;17:223–8.

    Article  CAS  PubMed  Google Scholar 

  36. Tuttolomondo A, Pecoraro R, Di Raimondo D, et al. Immune-inflammatory markers and arterial stiffness indexes in subjects with acute ischemic stroke with and without metabolic syndrome. Diabetol Metab Syndr. 2014;6:28.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Vila N, Castillo J, Davalos A, Esteve A, Planas AM, Chamorro A. Levels of anti-inflammatory cytokines and neurological worsening in acute ischemic stroke. Stroke. 2003;34:671–5.

    Article  CAS  PubMed  Google Scholar 

  38. Protti GG, Gagliardi RJ, Forte WC, Sprovieri SR. Interleukin-10 may protect against progressing injury during the acute phase of ischemic stroke. Arq Neuropsiquiatr. 2013;71:846–51.

    Article  PubMed  Google Scholar 

  39. Ouyang W, Rutz S, Crellin NK, Valdez PA, Hymowitz SG. Regulation and functions of the IL-10 family of cytokines in inflammation and disease. Annu Rev Immunol. 2011;29:71–109.

    Article  CAS  PubMed  Google Scholar 

  40. Morita Y, Takizawa S, Kamiguchi H, Uesugi T, Kawada H, Takagi S. Administration of hematopoietic cytokines increases the expression of anti-inflammatory cytokine (IL-10) mRNA in the subacute phase after stroke. Neurosci Res. 2007;58:356–60.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

This study was funded by the Shandong Province Science and Technology Program (2009GG20002023). We would like to acknowledge the helpful comments on this paper received from our reviewers.

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Correspondence to Chuan-Zhu Yan.

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Diao, ZY., Wang, CL., Qi, HS. et al. Significance of decreased serum interleukin-10 levels in the progression of cerebral infarction. Clin Exp Med 16, 203–211 (2016). https://doi.org/10.1007/s10238-015-0346-5

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  • DOI: https://doi.org/10.1007/s10238-015-0346-5

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