Nucleosomes in serum of patients with early cerebral stroke

Background: Nucleosomes are cell death products that are elevated
in serum of patients with diseases that are associated with massive
cell destruction. We investigated the kinetics of circulating
nucleosomes after cerebral stroke and their correlation with the
clinical status. Methods: In total, we analyzed nucleosomes by
ELISA in sera of 63 patients with early stroke daily during the
first week after onset. For correlation with the clinical
pathology, patients were grouped into those with medium to slight
functional impairment (Barthel Index BI >= 50) and those with
severe functional impairment (BI < 50). Results: Patients with
BI >= 50 showed a continuous increase in nucleosomes until day 5
(median: 523 arbitrary units, AU) followed by a slow decline. In
contrast, patients with BI < 50 showed a steeper initial
increase reaching a maximum already on day 3 (869 AU). Both, days
after stroke (p < 0.001) and BI (p < 0.001), had a
significant influence on nucleosome concentrations, respectively.
Consistently, patients with BI < 50 had a significantly larger
area under the curve (AUC/day) of nucleosome values during the
first week after stroke (800 AU) than patients with BI >= 50
(497 AU; p = 0.031). Concerning the infarction volume, nucleosomes
showed significant correlations for the concentrations on day 3 (r
= 0.43; p = 0.001) and for the area under the curve (r = 0.34; p =
0.016). Conclusion: Even if nucleosomes are nonspecific cell death
markers, their release into serum after cerebral stroke correlates
with the gross functional status as well as with the infarction
volume and can be considered as biochemical correlative to the
severity of stroke. Copyright (c) 2006 S. Karger AG, Basel.