Inflammatory Markers are Associated with Ischemic Stroke among Indigenous Africans: Evidence from the SIREN Study

Abstract

Background: Inflammation might predispose to worse outcomes after an ischemic stroke. This has not been characterized among indigenous Africans. Purpose: We investigated the association between inflammatory biomarkers, stroke severity, and outcomes in Africans. Methods: This is a retrospective analysis of a prospective study, including 90 participants with confirmed ischemic stroke selected from the Stroke Investigative Research & Educational Network (SIREN) cohort and 90 controls matched by age, sex, and ethnicity. Plasma concentrations of 368 protein biomarkers were analyzed (Olink® Explore 384 Inflammation panel) and compared between cases and controls. Further, we investigated the association between these proteins and stroke severity, lesion volume, and one-month post-stroke disability and fatality. Results: Differential protein expression analysis revealed 23 up-regulated and 14 down-regulated proteins in stroke cases versus controls. Among the up-regulated proteins, agouti-related protein (AgRP) and tumor necrosis factor receptor superfamily member 11A (TNFRSF11A) were the most significantly up-regulated, while interleukin-1 beta (IL-1β) and integrin alpha-11 (ITGA11) were the most down-regulated proteins. Logistic regression analysis identified 72 proteins that were associated with stroke severity independent of age and sex. Among these, complement C1q subcomponent subunit A (C1qa) exhibited the strongest associations. Additionally, 14 proteins including C-C motif chemokine 23 (CCL23) were found to be associated with one-month post-stroke disability. Conclusion: Stroke disability and severity were associated with inflammation in an indigenous African population. The identified biomarkers might be useful for predicting stroke outcome or serve as therapeutic target.