Inflammatory and Oxidative Biomarkers in Ischemic Stroke

BACKGROUND: Ischemic stroke is a major neurological emergency in which cerebral vessel occlusion triggers a cascade of inflammatory responses, endothelial dysfunction, and oxidative injury. These biochemical changes may influence the extent of neuronal damage and clinical severity. Hence, the present study was undertaken to evaluate selected inflammatory and oxidative stress biomarkers in patients with acute ischemic stroke and to compare their levels with those of age- and sex-matched healthy controls. MATERIALS AND METHODS: This hospital-based case-control study included 100 subjects, comprising 50 clinically and radiologically confirmed ischemic stroke patients and 50 healthy controls. Blood samples were collected within 24 hours of admission in stroke patients. Serum C-reactive protein (CRP), interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-α), malondialdehyde (MDA), nitric oxide (NO), superoxide dismutase (SOD), catalase, and reduced glutathione (GSH) were analysed using standard laboratory methods. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS). Data were analysed using appropriate statistical tests, and p < 0.05 was considered significant. RESULTS: The mean age of stroke patients was 61.8 ± 10.4 years, while controls had a mean age of 59.6 ± 9.8 years. Serum CRP was significantly higher in stroke patients than in controls (18.6 ± 6.9 mg/L vs. 4.2 ± 1.8 mg/L, p < 0.001). IL-6 (42.5 ± 13.7 pg/mL vs. 12.8 ± 5.4 pg/mL, p < 0.001), TNF-α (31.4 ± 9.6 pg/mL vs. 10.7 ± 4.1 pg/mL, p < 0.001), MDA (6.8 ± 1.9 nmol/mL vs. 2.9 ± 0.8 nmol/mL, p < 0.001), and NO (58.2 ± 14.5 µmol/L vs. 32.6 ± 9.3 µmol/L, p < 0.001) were elevated in cases. Antioxidant markers were reduced, with lower SOD (72.4 ± 18.6 U/mL vs. 118.5 ± 24.3 U/mL), catalase (34.8 ± 9.2 U/mL vs. 56.7 ± 11.4 U/mL), and GSH (5.1 ± 1.4 µmol/L vs. 8.6 ± 2.1 µmol/L) in stroke patients. CRP, IL-6, and MDA showed a positive correlation with NIHSS score. Among the 50 ischemic stroke patients, 14 (28.0%) had mild stroke, 24 (48.0%) had moderate stroke, and 12 (24.0%) had severe stroke based on NIHSS grading. CONCLUSION: Ischemic stroke patients showed marked inflammatory activation and oxidative imbalance, reflected by increased CRP, IL-6, TNF-α, MDA, and NO, along with reduced antioxidant defence. These biomarkers may support assessment of stroke severity and vascular injury.