Page 158 - Read Online

Lu et al. Microbleeds and inflammatory marker levels

CMB can be seen as the common downstream product found to have an elevated risk of hemorrhagic
of hypertensive vasculopathy and cerebral amyloid stroke or an antithrombotic-related hemorrhagic
angiopathy pathways. In old patients, hemosiderin complication. In the near future, we may reduce
[29]
[22]
deposited around the capillaries, the hemosiderin levels of circulating inflammatory markers to prevent
leaking through expansile vascular clearance would CMB from happening.
accelerate the inflammation and result in small vessel
disease and CMB. Previous studies found that DECLARATIONS
[23]
levels of hs-CRP, IL-6, and IL-18 are related to both
deep and lobar CMB. Hoshi et al. found that IL-6 Authors’ contributions
[13]
[22]
could result in increase of hs-CRP as an important Substantially contributed to the general idea and
cytokine in inflammation, it can be a predictor of SLI. design of the study: C. Li, Z.R. Jia
Koh et al. found that the levels of MMP-9 and hs- Took part in designing the protocol: Y. Song
[24]
CRP were significantly higher in patients with CMB Contributed to data collection and drafted the
than in those without. Hemosiderin of brain microbleed manuscript: Q.L. Lu
is well known to activate MMP-9, increased MMP- Helped with the data analysis: L. Wang
9 activity enhances inflammatory markers related Read and approved the final manuscript: Q.L. Lu, C.
to deterioration of neurological function in ischemic Li, Y. Song, L. Wang, Z.R. Jia
stroke. Pantoni et al. found that destruction of
[24]
[25]
Blood Brain Barrie played an important role during the Acknowledgments
process of CMB. MMP-9 would destroy the blood-brain We thank the laboratory and X-ray Department
barrier (BBB) by degrading the extracellular matrix, of Tianjin 5th Center Hospital for their secretarial
leading to the increased permeability of BBB. The assistance.
[26]
animal experiment also proved a close relationship
between increased MMP-9 and chronic destruction Financial support and sponsorship
of BBB. CMB resulting from cerebral amyloid This study was supported by a grant from Science
[27]
angiopathy could be confirmed as the presence of and Technology Fund Project of Tianjin Health Bureau
β-amyloid in the vessel wall, which activated microglia (No. 2013KZ021).
and T lymphocytes expressing heme oxygenase-1 Conflicts of interest
activity and complement activation were prominent.
The above studies supported that inflammatory The authors declare that they have no conflict of
interest.
reaction participate the dysfunction of vascular
endothelium and destruction of BBB, finally leading to Patient consent
the occurrence of CMB. [28]
Informed consent was obtained from all individual
participants included in the study.
This study has several limitations. Firstly, the results
of this research have limited effectiveness because Ethics approval
of the relatively small number of cases, especially All procedures performed in the studies involving
deep or infratentorial and lobar CMB group. More human participants were in accordance with the
patients must be enrolled in a large clinical trial. ethical standards of the institutional and/or national
Secondly, in the cross-sectional study, we did not research committee and with the 1964 Helsinki
recruit the general population as a control group. Declaration and its later amendments or comparable
The relationships of CMB and inflammation in ethical standards.
the general population remain unclear. Thirdly,
we choose hs-CRP, IL-6 and MMP-9 to study the REFERENCES
relationship between inflammatory marker and CMB.
Other inflammatory factors need to be studied further 1. Greenberg SM, Vernooij MW, Cordonnier C, Viswanathan A, Al-
to confirm the relationship between inflammatory Shahi Salman R, Warach S, Launer LJ, Van Buchem MA, Breteler
marker and CMB. MM; Microbleed Study Group. Cerebralmicrobleeds: a guide to
detection and interpretation. Lancet Neurol 2009;8:165-74.
In conclusion, our results demonstrated that CMB 2. Yates PA, Villemagne VL, Ellis KA, Desmond PM, Masters CL,
were closely related with the age, prevalence of Rowe CC. Cerebral microbleeds: a review of clinical, genetic, and
hypertension, SLI, WML, MoCA Score, the using rate 3. neuroimaging associations. Front Neurol 2013;4:205.
Charidimou A, Kakar P, Fox Z, Werring DJ. Cerebral microbleeds
of antithrombotic drugs, levels of hs-CRP, IL-6, and and recurrent stroke risk: systematic review and meta-analysis of
MMP-9, suggesting a role of inflammatory processes prospective ischemic stroke and transient ischemic attack cohorts.
in CMB. Patients with CMB have been consistently Stroke 2013;44:995-1001.
150 Neuroimmunology and Neuroinflammation ¦ Volume 4 ¦ August 08, 2017