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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter / Tate, Jillian R.

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Polymorphisms of the inflammatory system and risk of ischemic cerebrovascular events

Wolfgang Lalouschek1 / Martin Schillinger2 / Kety Hsieh3 / Georg Endler4 / Stefan Greisenegger5 / Rodrig Marculescu6 / Wilfried Lang7 / Oswald Wagner8 / Suzanne Cheng9 / Christine Mannhalter10











Corresponding author: Prof. Wolfgang Lalouschek, MD, University Clinic of Neurology, Clinical Department of Clinical Neurology, Waehringer Guertel 18-20, 1097 Vienna, Austria Phone: +43-1-40400-3117, Fax: +43-1-40400-3141

Citation Information: Clinical Chemical Laboratory Medicine. Volume 44, Issue 8, Pages 918–923, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: 10.1515/CCLM.2006.165, July 2006

Publication History

January 26, 2006
April 21, 2006
Published Online:


Background: Chronic and acute infections are associated with an increased risk of stroke. The inflammatory response can be influenced by functional polymorphisms in components of the immune system. We hypothesized that these polymorphisms may also modulate the risk of ischemic cerebrovascular events.

Methods: We determined the frequency of polymorphisms in tumor necrosis factor-α[(TNF-α) G(–376)A, G(–244)A, G(–238)A, G(–308)A], Toll-like receptor 4 [(TLR4) Gly299Asp and Thr399Ile], interleukin-1-receptor antagonist [(IL-1-RA) intron 2 variable-number tandem repeat], monocyte differentiation antigen CD14 receptor C(–260)T, and interleukin-6 [(IL-6) G(–174)C] genes in 404 patients with acute stroke or transient ischemic attack before the age of 60 years and in 415 healthy individuals. We also tested for interactions between genotypes, recent febrile episodes and stroke risk.

Results: None of the polymorphisms was associated with an increased risk of stroke after adjustment for age and gender. Following multivariate adjustment, carriers of the TNF-α (–308)A allele, the IL-1-RA 2* allele or the IL-6 (–174)C allele appeared to have an increased risk of stroke in association with a febrile episode prior to strokes.

Conclusion: In our study none of the investigated polymorphisms of the inflammatory system was associated with the risk of acute cerebrovascular events before the age of 60 years. However, post-hoc analyses indicate that some polymorphisms seem to contribute to the risk of stroke in combination with fever.

Clin Chem Lab Med 2006;44:918–23.

Keywords: infection; inflammation; interleukins; polymorphism; stroke; tumor necrosis factor

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