INTRODUCTION
Astrocyte is involved in reactive astrogliosis process signaled by the expressionof glial fibrilary acidic protein (GFAP). Another anti-inflammatory cytokine triggered by astrocyte is transforming growth factor beta (TGFβ) which take part in angiogenesis and neurogeneration after stroke. We sought to determine the role of astrocyte through the expression of GFAP and TGFβ in acute stroke patients and its relation to stroke severity and outcome.
METHODS
Patients with anterior ischemic stroke less than 72 hours of onset was studied. Blood sample were drawn and stroke severity was examined by the time of admission, a week after, and a month after the onset, using the NIHSS, Barthel and mRankin Scale.
RESULTS
We evaluate 64 subject. Mean age was 58.7 with male predominance (72%). As much as 93.8% has hypertension, and 76.6% were lacunar anterior circulation infarct. More than half of the subject came with moderate stroke severity. A significant correlation was found between serum GFAP on admission and NIHSS [after 1 week (r=0.255;p=0.042) and after 1 month (r=0.266;p=0.034)]. The concentration of TGFβ was inversely correlated with NIHSS (on admission, a week, a month) and mRankin Scale. Subject with severity scale of moderate severe on 1 week shows a higher GFAP than those with mild symptoms (p=0.0054). Subject with mild symptoms on 1 month had a higher mean of TGFβ than those with moderate severe scale (p=0.046).
CONCLUSION
Higher concentration of GFAP seems to correlate with more severe stroke
symptoms. On the contrary, higher serum TGFβ indicates a milder symptom and a better stroke outcome.
Keywords: GFAP, TGFβ, stroke severity