Glucocorticoid Resistance is Associated with Poor Functional Outcome After Stroke
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ORIGINAL RESEARCH
Glucocorticoid Resistance is Associated with Poor Functional Outcome After Stroke Anna Maria Lopatkiewicz1 · Elzbieta Gradek‑Kwinta1 · Mateusz Czyzycki1 · Joanna Pera1 · Agnieszka Slowik1 · Tomasz Dziedzic1 Received: 22 November 2019 / Accepted: 18 February 2020 © The Author(s) 2020
Abstract Systemic inflammation is associated with poor outcome after stroke. Glucocorticoids (GCs) play a fundamental role in limiting inflammation. The aim of this study was to explore the associations between GC sensitivity, systemic inflammation, and outcome after ischemic stroke. The study population compised 246 ischemic stroke patients (median age: 69.0 years; 41.1% female). To assess GC sensitivity, we incubated venous blood samples that were obtained at day 3 after stroke with lipopolysaccharide (10 ng/mL) and dexamethasone (10–6 mol/L). We defined the GC sensitivity index as the ratio of tumor necrosis factor α (TNFα) released after blood stimulation with lipopolysaccharide and dexamethasone to the amount of TNFα released after blood stimulation with lipopolysaccharide alone. A higher index indicates higher GC resistance. The patients with poor functional outcome had a higher GC sensitivity index than those with good outcome (median: 16.1% vs. 13.5%, P
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