{
  "abstract": "Introduction Stroke is the second leading cause of death and the leading cause of long-term disability worldwide. Although thrombolytics and mechanical thrombectomy (MT) have improved outcomes for large vessel occlusions (LVO), a subset of patients experience poor recovery despite successful intervention. The inflammatory response to acute ischemia may contribute to this variability. Neutrophil extracellular traps (NETs), extracellular web-like structures released by activated neutrophils, promote thrombosis and inflammation. Evaluation of circulating NET-associated biomarkers may provide insight into stroke severity and clinical outcomes.Methods An IRB-approved, prospective single-center study was performed to collect clinical and biologic data from patients undergoing MT for acute ischemic stroke. Plasma samples were obtained at the time of stroke onset and analyzed for NET-associated biomarkers, including calprotectin, neutrophil elastase (NE)-DNA complexes, and myeloperoxidase (MPO)-DNA complexes. Healthy controls were included for comparison. Biomarker concentrations were quantified using ELISA. Comparisons between stroke patients and controls were performed using Mann-Whitney U testing. Associations between biomarker levels and clinical variables, including recanalization status (TICI score) and discharge modified Rankin Scale (mRS), were assessed using Spearman correlation and nonparametric testing.Results A total of 33 stroke patients and 9 healthy controls were included. Baseline plasma levels of NET-associated biomarkers were higher in stroke patients compared to controls, although these differences did not reach statistical significance. Median calprotectin levels were 1562 pg/mL in stroke patients versus 1332 pg/mL in controls (p = 0.54). NE-DNA levels demonstrated a trend toward higher concentrations in stroke patients (median 100 pM vs 78 pM, p = 0.075), while MPO-DNA levels were similar between groups (median 47 pM vs 24 pM, p = 0.67). Among stroke patients, higher calprotectin levels were significantly associated with worse functional outcomes at discharge, as measured by modified Rankin Scale (Spearman ρ = 0.53, p = 0.004), and were elevated in patients with poor functional outcomes (mRS >2, p = 0.016). NE-DNA levels demonstrated a moderate positive correlation with age (ρ = 0.39, p = 0.025). No significant associations were observed between NET biomarkers and recanalization success. After correction for multiple comparisons, these associations did not remain statistically significant.Conclusion Circulating NET-associated biomarkers are detectable in acute ischemic stroke and demonstrate trends toward elevation compared to healthy controls. Calprotectin, a marker of neutrophil activation, is associated with worse functional outcomes and may serve as a prognostic biomarker. These findings support further investigation of inflammatory pathways in stroke and highlight the need for larger studies to better define the role of NETs in stroke pathophysiology and recovery.Disclosures D. Nistal: 1; C; Robert J. Dempsey, MD, Cerebrovascular Research Award. L. Basner: None. J. Chapa: None. C. Lood: None.",
  "authors": [
    {
      "affiliations": [
        "Neurological Surgery, University of Washington, Seattle, WA"
      ],
      "name": "D Nistal"
    },
    {
      "affiliations": [
        "Neurological Surgery, University of Washington, Seattle, WA"
      ],
      "name": "L Basner"
    },
    {
      "affiliations": [
        "Deparment of Rheumatology, University of Washington, Seattle, WA"
      ],
      "name": "J Chapa"
    },
    {
      "affiliations": [
        "University of Washington, Seattle, WA"
      ],
      "name": "M Levitt"
    },
    {
      "affiliations": [
        "Neurological Surgery, University of Washington, Seattle, WA"
      ],
      "name": "C Lood"
    },
    {
      "affiliations": [
        "Neurological Surgery, University of Washington, Seattle, WA"
      ],
      "name": "S Chen"
    }
  ],
  "title": "O-041 The role of neutrophil extracellular traps (NETs) and inflammatory biomarkers in acute ischemic stroke severity and functional outcomes",
  "uid": "cbda6874-c9c0-5371-a0ff-549a151ba247"
}