Inflammation and thrombosis in vascular lesion in ischemic stroke

Abstract

Inflammation has been shown to be important in the process of atherothrombotic events including myo-cardial infarction and stroke. We have clarified the value of inflammatory markers such as high-sensitivity CRP (hs-CRP) and soluble ICAM-1 for prediction of atherosclerosis progression with carotid ultrasound. Furthermore, we have demonstrated the association between serum levels of inflammatory cytokine, inter-leukin-6 and plaque echogenecity, suggesting the involvement of inflammation in plaque stability. In patients with obesity and metabolic syndrome, both hs-CRP and plasminogen activator inhibitor-1 levels increased, suggesting upregulation of inflammation and thromobosis activity in those patients. Furthermore, in patients with small vessel diseases such as silent brain infarction and white matter lesion, hs-CRP has been shown to be associated with the presence of silent infarction or the degree of white matter lesion. Those findings highlighted the inflammatory process in the vascular lesion underlying atherothromobotic and lacunar infarction. Recent studies have clarified the CD40 pathway connecting the inflammation and thrombosis in the athero-motous plaque. Therapeutic strategy to inhibit both inflammation and thrombosis will be potential for pre-venting ischemic stroke.