Analyzing the impacts of primary interventional and thrombolytic treatment on oxidant-antioxidant status and lymphocyte dna damage in cases of acute ischemic stroke

Purpose: This study aimed to investigate the impacts of thrombolysis and thrombectomy on lymphocyte DNA damage and oxidative stress parameters for the treatment of adult patients with ischemic stroke in early post-stroke period (within the first 4-6 hour of stroke) based on clinical and radiological findings. Materials and methods: Over a 7-month period (May 2014 through November 2014), 62 consecutive adult patients who presented to the Emergency Department of Bezmialem Vakif University and diagnosed as an acute ischemic stroke were included in this prospective clinical study. Thirty-two patients who met the inclusion criteria and 30 eligible healthy volunteers as control subjects were enrolled. Patients were divided into 3 groups according to their National Institute of Health Stroke Scales (NIHSS) on admission. Additionally, patients were stratified into three different groups based on modified Rankin Scale (mRS) at 24 h after treatment. Plasma lymphocyte DNA damage and Total Oxidant Status (TOS), Total Antioxidant Status (TAS) and Oxidative Stress Index (OSI) were assessed in all groups classified with respect to NIHSS and mRS, both on admission and at 24 h after the treatment. The results were compared between the groups. Results: Plasma TOS and OSI levels and lymphocyte DNA damage were found to be significantly higher, whereas plasma TAS levels were significantly lower in patients with stroke compared with those in the controls (all comparisons, p<0.001). According to the comparison of NIHSS groups with respect to the stroke severity; increased lymphocyte DNA damage levels and decreased TAS levels were observed (p< 0.001 and p=0.034, respectively). When the patients were classified into subgroups with respect to mRS, plasma TOS and OSI levels and lymphocyte DNA damage tended to be higher in group 3 which comprised patients with the most neuronal dysfunction compared to those in groups 1 and 2 (p=0.003, p=0.001 and p=0.006, respectively). Conclusion: Lymphocyte DNA damage and TAS, as biomarkers of early oxidative changes can be regarded as an objective alternative criterion to the stroke assessment scales for determining severity of brain damage in patients with ischemic stroke. Furthermore, we suggest that lymphocyte DNA damage, TOS and OSI levels can be regarded as an early biological indicators to assess neurologic health and well being and the effectiveness of the thrombolytic treatment or endovascular thrombectomy in such patients. Keywords: Acute ischemic stroke, TOS, TAS, lymphocyte DNA damage, thrombolytic treatment, thrombectomy