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(Stroke. 2002;33:1135.)
© 2002 American Heart Association, Inc.

Short Communications

Inflammation and Stroke

The Leiden 85-Plus Study

E. van Exel, MD; J. Gussekloo, MD, PhD; A.J.M. de Craen, PhD; A. Bootsma-van der Wiel, MD; M. Frölich, PhD R.G.J. Westendorp, MD, PhD

From the Section of Gerontology and Geriatrics, Department of General Internal Medicine (E. van E., J.G., A.J.M. de C., A.B., R.G.J.W.), Department of Clinical Epidemiology (A.J.M. de C.), and Department of Clinical Chemistry (M.F.), Leiden University Medical Center (Netherlands).

Correspondence to Jacobijn Gussekloo, MD, PhD, Leiden 85-Plus Study, Leiden University Medical Center, Gerontology and Geriatrics, C2-R, PO Box 9600, 2300 RC Leiden, Netherlands. E-mail JGussekloo{at}lumc.nl

Abstract

Background— Experimental evidence indicates that interleukin-10 (IL-10) deficiency is associated with the development of cardiovascular and cerebrovascular disease. We analyzed the relation between low IL-10 production levels, history of stroke, and incident fatal stroke.

Summary of Report— All 85-year-old inhabitants of Leiden, Netherlands (n=599) were visited at their place of residence (response rate, 87%). Production levels of the anti-inflammatory cytokine IL-10 were assessed in a whole blood assay whereby lipopolysaccharide was used as a stimulus. Plasma concentrations of C-reactive protein (CRP) were also used as a marker of inflammation. A history of stroke was obtained at baseline (prevalence, 10%). The number of fatal strokes was prospectively obtained for a median follow-up of 2.6 years (incidence, 1.82 per 100 person-years at risk). Subjects with a history of stroke had significantly lower median IL-10 production levels at baseline than subjects without stroke (558 versus 764 pg/mL; P<0.05). They also had significantly higher median CRP concentrations (6 versus 3 mg/L; P<0.05). The odds ratio for a history of stroke increased to 2.30 (95% CI, 1.12 to 4.72) over strata representing decreasing production levels of IL-10. The relative risk for incident fatal stroke was 2.94 (95% CI, 1.01 to 8.53) when we compared subjects with low or intermediate baseline IL-10 production levels to those with high production levels of IL-10.

Conclusions— Our data support the hypothesis that subjects with low IL-10 production levels have an increased risk of stroke.

Key Words: C-reactive protein • cytokines • inflammation • interleukin-10 • stroke

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