Abstract
Performing endovascular treatment (EVT) in acute ischemic stroke (AIS) patients allows a port-of-entry for intracranial biological sampling. Here, we tested the hypothesis that specific immune players represent molecular contributors to disease, outcome biomarkers, and potential targets for modifying AIS. We collected post-clot blood samples immediately before EVT and interrogated the pro-inflammatory environment.We obtained blood samples from n = 75 subjects presenting with large vessel occlusion (LVO) of the anterior circulation and undergoing EVT. Intracranial blood samples were obtained by microcatheter aspiration, as positioned for stent deployment. Peripheral blood samples were collected from the femoral artery. Plasma samples were quality-controlled by electrophoresis and analyzed using a Mesoscale multiplex for targeted inflammatory and vascular factors.We quantified 37 protein biomarkers in our sample cohort. Through multivariate analysis, adjusted for age, intravenous thrombolysis, pre-treatment NIHSS and ASPECT scores, we found that post-clot blood levels of IL-6 were significantly correlated (adjusted p-value < 0.05) with disability assessed by the modified Rankin score (mRS) at 90 days, with medium effect size. Chemokine (C-C) ligand 17 CCL17/TARC levels were inversely correlated with mRS. When examining peripheral blood, these correlations did not reach statistical significance after correction. Intracranial biomarkers IL-6 and SAA levels were specifically associated with a lower likelihood of favorable outcomes, defined as mRS 0-2.Our findings show a signature of blood inflammatory factors at the cerebrovascular occlusion site. The correlations between these acute-stage biomarkers and mRS outcome support an avenue for add-on immune modulatory strategies in AIS.