Inflammatory and Infectious Burden and Risk of Stroke

炎症和感染负担以及中风风险

• 批准号: 6848008
• 负责人: MITCHELL S ELKIND
• 金额: $ 30.25万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-03-01 至 2009-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6848008
• 关键词: African American; Hispanic Americans; acute phase protein; bacterial disease; biomarker; caucasian American; cerebral ischemia /hypoxia; clinical research; data collection methodology /evaluation; disease /disorder proneness /risk; human subject; immunologic assay /test; inflammation; nephelometry; racial /ethnic difference; stroke; virus diseases

DESCRIPTION (provided by applicant): Inflammation is increasingly recognized to play a central role in atherosclerosis and coronary artery disease, and peripheral blood markers of inflammation have been associated with cardiac events. The relationship of these potentially modifiable risk markers to ischemic stroke risk is less clear. Additional epidemiological studies have suggested that the burden of past exposure to common infectious diseases may be one of the factors contributing to increased levels of inflammation. The proposed research study will capitalize on the on-going Northern Manhattan Study (N INDS R01 29993, PI RL S acco), a prospective cohort study of stroke risk factors in a multi-ethnic urban population, to test the following hypotheses: (1) high-sensitivity C -reactive protein and other inflammatory markers (serum amyloid A, interleukin 6, tumor necrosis factor receptor levels) are independent risk factors for (a) ischemic stroke and (b) ot her vascular outcomes in whites, blacks and Hispanics; (2) the burden of common infectious serologies (C. pneumoniae, H.pylori, CMV, EBV, HSV 1 and 2) is an independent risk factor for stroke and other vascular outcomes in these populations; (3) these inflammatory and infectious marker s are associated with sub-clinical vascular brain diseases seen on MRI scanning, such as white matter hyperintensities and silent infarcts. Levels of these markers will be measured using nephelometric and immunoassay techniques on stored baseline serum samples from 2000 of 3298 initially stroke-free subjects, of whom 1400 will undergo MRI scanning as part of the parent project. Follow-up serum samples will also be collected on these 1400 participants. Outcomes of ischemic stroke, total stroke, myocardial infarction, vascular mortality and total mortality will be ascertained. Cox proportional hazard model analysis will be used to assess the significance of the main exposure variables after adjustment for other risk factors, and inflammatory and infectious markers will be analyzed as time dependen t covariates when follow up values are available. The cross-sectional associations between inflammatory and infectious markers and quantitative MRI abnormalities will also be assessed.

描述（由申请人提供）：越来越多的炎症在动脉粥样硬化和冠状动脉疾病中起着核心作用，炎症的外周血标志物与心脏事件有关。这些潜在的可修改风险标志与缺血性中风风险的关系尚不清楚。其他流行病学研究表明，过去暴露于常见传染病的负担可能是导致炎症水平增加的因素之一。 The proposed research study will capitalize on the on-going Northern Manhattan Study (N INDS R01 29993, PI RL S acco), a prospective cohort study of stroke risk factors in a multi-ethnic urban population, to test the following hypotheses: (1) high-sensitivity C -reactive protein and other inflammatory markers (serum amyloid A, interleukin 6, tumor necrosis factor受体水平）是（a）缺血性中风的独立危险因素，（b）在白人，黑人和西班牙裔中的血管结局； （2）常见感染血清的负担（C.肺炎，H.Pylori，CMV，EBV，HSV 1和2）是这些人群中中风和其他血管结果的独立危险因素； （3）这些炎症和感染性标记物与MRI扫描中看到的亚临床血管脑疾病有关，例如白质超强度和无声梗塞。这些标记的水平将使用来自3298个最初无中风的受试者的2000年基线血清样品的肾上腺计量和免疫测定技术来测量，其中1400名将接受MRI扫描，作为父母项目的一部分。这1400名参与者还将收集随访血清样品。将确定缺血性中风，总中风，心肌梗塞，血管死亡率和总死亡率的结果。 COX比例危害模型分析将用于评估其他风险因素调整后主要暴露变量的重要性，并且在可用后续值时，将分析炎症和传染性标记。还将评估炎症和传染性标记与定量MRI异常之间的横截面关联。