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Neutrophil extracellular traps correlate with severity and prognosis in patients with ischemic stroke: a systematic review and meta-analysis

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Abstract

Background and objective

A correlation between neutrophil extracellular traps (NETs) and ischemic stroke (IS) has been hypothesized, but the results of relevant studies remain controversial. The purpose was to determine whether NETs have an impact on ischemic stroke.

Methods

The studies on the correlation between NETs and IS were retrieved from CNKI, Wanfang Data, VIP, CBM, PubMed, Web of Science, Embase, and Cochrane databases by computer from the start of the database to December 2022. The study adhered to PRISMA guidelines. The PICOS model was used to create inclusion criteria. Two researchers screened the literature and extracted the relevant data. The quality of the included studies was evaluated using the NOS and the 11 items recommended by the AHRQ, and meta-analysis was completed using Stata 15.1 software.

Results

The researchers included 752 patients in 7 studies (4 case–control studies and 3 cross-sectional studies). The meta-analysis found NETs are positively associated with the severity of IS at the time of onset [r(95% CI) = 0.31(0.24, 0.38), P < 0.001]. NETs are positively associated with a worse prognosis of IS [r(95% CI) = 0.34(0.13, 0.53), P = 0.003].

Conclusion

The presence of NETs is positively related to the severity and prognosis of IS. Higher levels of NETs indicate a more severe disease and a poorer prognosis. Because the number and quality of included studies are limited, the above results must be supported by further high-quality studies.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022356619.

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Data availability

The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author/s.

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Funding

Project of Sichuan Province Administration of Traditional Chinese Medicine, China (No. 2020LC0141); Project leader: Shuang-Chun Ai. (2) Project of Sichuan Province Science and Technology Support Program, China (No. 2023YF0337); Project leader: Shuang-Chun Ai.

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Authors and Affiliations

  1. School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China

    Zhuo-Rao Wu, Tian-Qi Zhou & Shuang-Chun Ai

  2. Department of Rehabilitation, Mianyang Hospital, Chengdu University of Traditional Chinese Medicine, Mianyang, 621053, China

    Shuang-Chun Ai

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  1. Zhuo-Rao Wu
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Contributions

ZW conceived, designed, and wrote the article; TZ searched and screened relevant literature, extracted information, and performed quality evaluation; ZW and TZ performed data processing and applied Stata software for meta-analysis; SA is responsible for the quality control and review of articles, and is responsible for the supervision and management.

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Correspondence to Shuang-Chun Ai.

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Wu, ZR., Zhou, TQ. & Ai, SC. Neutrophil extracellular traps correlate with severity and prognosis in patients with ischemic stroke: a systematic review and meta-analysis. Acta Neurol Belg 124, 513–522 (2024). https://doi.org/10.1007/s13760-023-02409-5

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