Published Online
on December 11, 2003

A more recent version of this article appeared on January 1, 2004

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Submitted on August 12, 2003
Accepted on September 2, 2003

Decreased Levels of Plasma Vitamin C and Increased Concentrations of Inflammatory and Oxidative Stress Markers After Stroke

Concepción Sánchez-Moreno PhD; John F. Dashe MD, PhD; Tammy Scott PhD; David Thaler MD, PhD; Marshal F. Folstein MD; and Antonio Martin MD, PhD^*

From the Nutrition and Neurocognition Laboratory, Jean Mayer USDA-Human Nutrition Research Center on Aging (C.S.-M., A.M.), and Tufts Medical School (T.S., M.F.F.), Tufts University, and Neurology Department, New England Medical Center (J.F.D., D.T.), Boston, Mass.

^* To whom correspondence should be addressed. E-mail: antonio.martin{at}tufts.edu.

Background and Purpose--Inflammatory response is a critical component of the complex pathophysiological response to stroke. Vitamin C has been shown to have important roles in cell performance and vascular function. In this study, we compared the nutritional status and levels of inflammatory markers between stroke cases and controls and assessed which antioxidant was associated with levels of inflammatory markers and oxidative stress among cases and controls.

Methods--We evaluated the nutritional status and measured plasma levels of vitamins C and E, uric acid, serum levels of C-reactive protein (CRP), the cytokines tumor necrosis factor- and interleukin-1, intercellular adhesion molecule-1 (ICAM-1) and chemokine monocyte chemoattractant protein-1 (MCP-1), prostaglandins PGE2 and PGI2, and 8-isoprostanes (8-epiPGF₂) for 15 patients with ischemic stroke within 2 to 5 days after stroke onset and for 24 control subjects.

Results--Stroke patients had significantly lower plasma levels of vitamin C than did controls. Among stroke patients, CRP was significantly elevated, as were the ICAM-1, MCP-1, and 8-epiPGF₂, but the prostaglandins PGE2 and PGI2 were significantly reduced. Interestingly, vitamin C concentration was significantly inversely correlated with the levels of CRP and 8-epiPGF₂ among stroke patients, and 8-epiPGF₂ was significantly associated with the levels of CRP. Uric acid was also elevated among stroke patients.

Conclusions--Lower vitamin C concentration, higher serum levels of inflammatory (CRP, ICAM-1, MCP-1) and oxidative stress (8-epiPGF₂) markers, and lower PGI2 and PGE2 concentrations among stroke patients indicate the presence of an inflammatory response associated with stroke.

Key words: antioxidants • C-reactive protein • inflammation • oxidative stress • stroke

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