Acute StrokeCRISPNCT03297827
Cytokine Registry Database of Stroke Patients
An observational study of Acute Stroke and Acute Ischemic Stroke, run by University of New Mexico at 1 site in United States.
Trial summary
Various molecules (cytokines: interleukins, interferons and neural proteins) found in human and animal blood are reported to be elevated in acute stroke (Ischemic and hemorrhagic). Cytokines can be pro-inflammatory or anti-inflammatory. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Acute Stroke, Acute Ischemic Stroke, Ischemic Stroke
- What is being tested?
- Serum and Urine measurement of cytokines.
- How many people
- 12 participants
- Where
- 1 siteUnited States
- Study dates
- 15 May 2019to 31 Dec 2021
- How long will I take part?
- 3 Years
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- Adult, Older adult
Study population: Two sets of serum samples will be obtained and analyzed; one upon admission to the hospital, and the 2nd, the next morning after overnight fasting. Both sets of blood draw are done for a clinical purpose, and any extra stored sample that is drawn and not used by pathology will be used for the study. Twenty-five percent of the total stroke patient serum samples will be matched by appropriate controls to confirm the level changes in stroke patients. ELISA-PCR assays will be performed on serum samples.
Who may be able to join
- All stroke patients (hemorrhagic and ischemic) presenting within 24 hours of onset who consent to our study.
- Adult Male/Female patients ages >18 years old
- Patients whose standard stroke admission order sets are obtained for clinical care.
- Patients with a history of MS may be included for future subanalysis.
Who cannot join
- History of prior stroke or any other neurodegenerative or neuroinflammatory disease (AD, PD, TM, PSP, etc.) except MS.
- Individuals ages <18 year
- Pregnant women
- Prisoners
Trial locations and contacts
1 site in 1 country.
United States1 site
Department of Neurology, University of New Mexico
Albuquerque, New Mexico, 87131-0007
About this study
Official title: A Prospective Cytokine Registry Database of Stroke (Ischemic and Hemorrhagic) Patients.
Various molecules (cytokines: interleukins, interferons and neural proteins) found in human and animal blood are reported to be elevated in acute stroke (Ischemic and hemorrhagic). Cytokines can be pro-inflammatory or anti-inflammatory. There are studies confirming level changes in serum of humans in the setting of several rheumatologic and cardiovascular diseases. As new molecular markers (cytokines and neural tissue markers) are established in scientific literature, stroke scientists are interested to evaluate the role of these in the pathophysiology of stroke. Investigators intend to study the role of these molecules in the development of stroke.
Acute stroke treatment has advanced considerably in the last 10 years with the establishment of comprehensive stroke centers and approval of neuro-interventional techniques. However, the molecular advancement in stroke pathogenesis has yet to reach a milestone in the world of stroke treatment. In our opinion, creating a database of acute stroke patients containing all pertinent medical demographics and clinical information along with the laboratory data, molecular levels of pertinent cytokines/neural factors from consenting patients, will help us define and delineate the most relevant molecules that are altered in acute stroke patients and can help us further improve us understanding of the role of these in acute stroke and thereby hopefully help in the improvement of our understanding and management of stroke. Moreover, analyzing the cytokines in stroke and ICH patients would help understand their role in the acute phase, which may become potential therapeutic adjuncts for tPA and endovascular thrombectomy.
Read the detailed description
Stroke is the fifth cause of all-cause mortality in US http://www.cdc.gov/stroke/facts.htm . Early identification and treatment not only prevent mortality but also morbidity. Recent advancement in the imaging and diagnostic technique and novel therapeutic modalities has dramatically helped to downgrade stroke from the list of top mortality index in the last 3 years. However, studies determining factors which help predict stroke outcome are still underway and much work needs to be done in this direction. Many factors currently are used to predict stroke outcome with varying results, for e.g. NIHSS is a good predictor of stroke outcome at 3 months; however, we need better predictors, outcome scales or outcome measures which are easy, reliable and has better specificity and sensitivity.
There is also some correlation of clinical and biochemical predictors in subarachnoid, cerebral venous thrombosis including Hunt and Hess, SAH score, WFNS-SAH grading among others with variable predictive quality. (Rosen et al; Neurocritical Care; April 2005, Volume 2, Issue 2, pp 110- 118: Subarachnoid hemorrhage grading scales).
During the acute phase of focal cerebral ischemia, there is an elevation of thrombin activity and a decline in fibrinolytic activity. Moreover, the role of pro-inflammatory cytokines has been proven in the last few decades, as markers of inflammation have been closely studied in mice models; there are indications that elevated levels correlate with the extent of ischemic injury. Various interleukins were found to be elevated in most if not all patients with acute ischemic stroke. Correlation of hemostatic (procoagulant and fibrinolytic markers) with inflammatory markers is under discussion, with no confirmed common marker identified as of yet.
As new cytokines and tissue markers are established in scientific literature, stroke scientists are interested in evaluating the role of these markers in the pathophysiology of stroke. The role of glial cell markers has been of remarkable interest. Recently, an astrocyte marker S100B has shown association with infarct size, neurological outcome, and prognosis. Moreover, analyzing the cytokines in stroke and ICH patients would help understand their role in the acute phase, which may become potential therapeutic adjuncts for tpa and endovascular thrombectomy. In summary, inflammation in acute stroke is an area of interest in the recent years, with the theoretical benefit of aborting the inflammatory chain during acute stroke might be useful in limiting stroke-related brain damage or hemorrhagic transformation in acute stroke.
- Being tested
- Serum and Urine measurement of cytokines.
- Keywords
- diagnosis, inflammatory biomarkers, cytokines, interleukin, interferons
- Medical subject headings
- Stroke, Ischemic Stroke, Hemorrhagic Stroke, Disease
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Serum and Urine measurement of cytokines.Other
To evaluate serum cytokine levels and identifying serum inflammatory markers (serum interleukin-33, IL-37, IL-36, IL-4, IL-6, IL-10, IL-17, IL-23, IL-1, TNF, PDGF, VEGFM TNFa, ANNULIN, MMP-9, MMP-12, NFk-B levels plus metabolic products like MPO, etc and glial factors like GMF, SI000B, GM6001) in patients with acute ischemic \& hemorrhagic stroke.
| Study group | Role | What they receive |
|---|---|---|
| Patients with stroke | Adult stroke patients with the stroke diagnosis will be recruited on admission to the University of New Mexico Hospital. Serum and Urine measurement of cytokines from two sets of serum and urine samples will be done on the admission and at the 24-hour mark respectively, form the specimens collected for the clinical purposes and are meant to be discarded. Consent will be taken from the patients to use these samples for our study. Receives: Other: Serum and Urine measurement of cytokines. | |
| Patients without stroke | Age/Sex matched adult control patients without the diagnosis of stroke, myocardial infarction, inflammatory flare, acute trauma, neurodegenerative or neuroinflammatory disease (AD, PD, TM, PSP, etc.) except MS will be recruited on admission to the University of New Mexico Hospital. Serum and Urine measurement of cytokines from two sets of serum and urine samples will be done on the admission and at the 24-hour mark respectively, form the specimens collected for the clinical purposes and are meant to be discarded. Consent will be taken from the patients to use these samples for our study. Receives: Other: Serum and Urine measurement of cytokines. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in the cytokine levels at the 24-hour mark from the baseline levels done at the time of admission for acute stroke.
Investigators will assess the variations in the levels of cytokines and inflammatory biomarkers at the 24-hour mark from the baseline levels done at the time of admission for acute stroke. Their correlation with each other may enable investigators to identify and streamline their efforts on only a few cytokines, interleukins, glial factors or metabolic products proved to be altered in acute stroke patients.
Measured: 24 Hours
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted29 Sep 2017
- Study start15 May 2019
- Primary completion31 Dec 2021
- Study completion31 Dec 2021
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Acute StrokeStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 12 participants (actual)
- Target duration
- 3 Years
Sponsor and investigators
- Lead sponsor
- University of New Mexico
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Michel Torbey, MD, MPH, Study chair, University of New MexicoAtif Zafar, MD, Principal investigator, University of New MexicoAsad Ikram, MD, Study director, University of New MexicoMudassir Farooqui, MD, MPH, Study director, University of New Mexico
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03297827
- Sponsor's protocol ID
- 17-315
- Acronym
- CRISP
- Status last verified
- Nov 2020
- First submitted
- 21 Sep 2017
- Last updated
- 8 Feb 2022
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Zafar A, Farooqui M, Ikram A, Suriya S, Kempuraj D, Khan M, Tasneem N, Qaryouti D, Quadri S, Adams HP, Ortega-Gutierrez S, Leira E, Zaheer A. Cytokines, brain proteins, and growth factors in acute stroke patients: A pilot study. Surg Neurol Int. 2021 Jul 27;12:366. doi: 10.25259/SNI_569_2021. eCollection 2021.
PubMed 34513133Farooqui M, Ikram A, Suriya S, Saleem S, Quadri SA, Robinson M, Ortega-Gutierrez S, Qeadan F, Leira E, Paul S, Zafar A. Cytokine Registry In Stroke Patients (CRISP): Protocol of a prospective observational study. Medicine (Baltimore). 2020 Jul 10;99(28):e20921. doi: 10.1097/MD.0000000000020921.
PubMed 32664088Zafar A, Ikram A, Jillella DV, Kempuraj D, Khan MM, Bushnaq S, Adam H, Ortega-Gutierrez S, Quadri SA, Farooqui M, Zaheer A, Leira EC. Measurement of Elevated IL-37 Levels in Acute Ischemic Brain Injury: A Cross-sectional Pilot Study. Cureus. 2017 Oct 11;9(10):e1767. doi: 10.7759/cureus.1767.
PubMed 29234571
Study at a glance
From the registry record, last updated by the sponsor on 8 Feb 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Prospective Cytokine Registry Database of Stroke (Ischemic and Hemorrhagic) Patients.
- ClinicalTrials.gov ID
- NCT03297827
- Acronym / sponsor ID
- CRISP / 17-315
- Keywords
- diagnosis, inflammatory biomarkers, cytokines, interleukin, interferons
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 12 participants (actual)
- Lead sponsor
- University of New MexicoUniversity, hospital or other
- Study start
- 15 May 2019 (actual)
- Primary completion
- 31 Dec 2021 (actual)
- Study completion
- 31 Dec 2021 (actual)
- First posted
- 29 Sep 2017 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Various molecules (cytokines: interleukins, interferons and neural proteins) found in human and animal blood are reported to be elevated in acute stroke (Ischemic and hemorrhagic). Cytokines can be pro-inflammatory or anti-inflammatory. There are studies confirming level changes in serum of humans in the setting of several rheumatologic and cardiovascular diseases. As new molecular markers (cytokines and neural tissue markers) are established in scientific literature, stroke scientists are interested to evaluate the role of these in the pathophysiology of stroke. Investigators intend to study the role of these molecules in the development of stroke.
Acute stroke treatment has advanced considerably in the last 10 years with the establishment of comprehensive stroke centers and approval of neuro-interventional techniques. However, the molecular advancement in stroke pathogenesis has yet to reach a milestone in the world of stroke treatment. In our opinion, creating a database of acute stroke patients containing all pertinent medical demographics and clinical information along with the laboratory data, molecular levels of pertinent cytokines/neural factors from consenting patients, will help us define and delineate the most relevant molecules that are altered in acute stroke patients and can help us further improve us understanding of the role of these in acute stroke and thereby hopefully help in the improvement of our understanding and management of stroke. Moreover, analyzing the cytokines in stroke and ICH patients would help understand their role in the acute phase, which may become potential therapeutic adjuncts for tPA and endovascular thrombectomy.
Detailed description
Stroke is the fifth cause of all-cause mortality in US http://www.cdc.gov/stroke/facts.htm . Early identification and treatment not only prevent mortality but also morbidity. Recent advancement in the imaging and diagnostic technique and novel therapeutic modalities has dramatically helped to downgrade stroke from the list of top mortality index in the last 3 years. However, studies determining factors which help predict stroke outcome are still underway and much work needs to be done in this direction. Many factors currently are used to predict stroke outcome with varying results, for e.g. NIHSS is a good predictor of stroke outcome at 3 months; however, we need better predictors, outcome scales or outcome measures which are easy, reliable and has better specificity and sensitivity.
There is also some correlation of clinical and biochemical predictors in subarachnoid, cerebral venous thrombosis including Hunt and Hess, SAH score, WFNS-SAH grading among others with variable predictive quality. (Rosen et al; Neurocritical Care; April 2005, Volume 2, Issue 2, pp 110- 118: Subarachnoid hemorrhage grading scales).
During the acute phase of focal cerebral ischemia, there is an elevation of thrombin activity and a decline in fibrinolytic activity. Moreover, the role of pro-inflammatory cytokines has been proven in the last few decades, as markers of inflammation have been closely studied in mice models; there are indications that elevated levels correlate with the extent of ischemic injury. Various interleukins were found to be elevated in most if not all patients with acute ischemic stroke. Correlation of hemostatic (procoagulant and fibrinolytic markers) with inflammatory markers is under discussion, with no confirmed common marker identified as of yet.
As new cytokines and tissue markers are established in scientific literature, stroke scientists are interested in evaluating the role of these markers in the pathophysiology of stroke. The role of glial cell markers has been of remarkable interest. Recently, an astrocyte marker S100B has shown association with infarct size, neurological outcome, and prognosis. Moreover, analyzing the cytokines in stroke and ICH patients would help understand their role in the acute phase, which may become potential therapeutic adjuncts for tpa and endovascular thrombectomy. In summary, inflammation in acute stroke is an area of interest in the recent years, with the theoretical benefit of aborting the inflammatory chain during acute stroke might be useful in limiting stroke-related brain damage or hemorrhagic transformation in acute stroke.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Target follow-up
- 3 Years
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Patients with stroke | – | Other: Serum and Urine measurement of cytokines.Adult stroke patients with the stroke diagnosis will be recruited on admission to the University of New Mexico Hospital. Serum and Urine measurement of cytokines from two sets of serum and urine samples will be done on the admission and at the 24-hour mark respectively, form the specimens collected for the clinical purposes and are meant to be discarded. Consent will be taken from the patients to use these samples for our study. |
| Patients without stroke | – | Other: Serum and Urine measurement of cytokines.Age/Sex matched adult control patients without the diagnosis of stroke, myocardial infarction, inflammatory flare, acute trauma, neurodegenerative or neuroinflammatory disease (AD, PD, TM, PSP, etc.) except MS will be recruited on admission to the University of New Mexico Hospital. Serum and Urine measurement of cytokines from two sets of serum and urine samples will be done on the admission and at the 24-hour mark respectively, form the specimens collected for the clinical purposes and are meant to be discarded. Consent will be taken from the patients to use these samples for our study. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Age groups
- Adult, Older adult
- Study population
- Two sets of serum samples will be obtained and analyzed; one upon admission to the hospital, and the 2nd, the next morning after overnight fasting. Both sets of blood draw are done for a clinical purpose, and any extra stored sample that is drawn and not used by pathology will be used for the study. Twenty-five percent of the total stroke patient serum samples will be matched by appropriate controls to confirm the level changes in stroke patients. ELISA-PCR assays will be performed on serum samples.
Key inclusion criteria (4 listed)
- All stroke patients (hemorrhagic and ischemic) presenting within 24 hours of onset who consent to our study.
- Adult Male/Female patients ages >18 years old
- Patients whose standard stroke admission order sets are obtained for clinical care.
- Patients with a history of MS may be included for future subanalysis.
Key exclusion criteria (4 listed)
- History of prior stroke or any other neurodegenerative or neuroinflammatory disease (AD, PD, TM, PSP, etc.) except MS.
- Individuals ages <18 year
- Pregnant women
- Prisoners
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Serum and Urine measurement of cytokines.To evaluate serum cytokine levels and identifying serum inflammatory markers (serum interleukin-33, IL-37, IL-36, IL-4, IL-6, IL-10, IL-17, IL-23, IL-1, TNF, PDGF, VEGFM TNFa, ANNULIN, MMP-9, MMP-12, NFk-B levels plus metabolic products like MPO, etc and glial factors like GMF, SI000B, GM6001) in patients with acute ischemic \& hemorrhagic stroke. | Other | Patients with stroke, Patients without stroke |
Primary outcome
Change in the cytokine levels at the 24-hour mark from the baseline levels done at the time of admission for acute stroke.
Time frame: 24 Hours
Investigators will assess the variations in the levels of cytokines and inflammatory biomarkers at the 24-hour mark from the baseline levels done at the time of admission for acute stroke. Their correlation with each other may enable investigators to identify and streamline their efforts on only a few cytokines, interleukins, glial factors or metabolic products proved to be altered in acute stroke patients.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 8 Feb 2022.
- Results publication: PubMed 34513133Zafar A, Farooqui M, Ikram A, Suriya S, Kempuraj D, Khan M, Tasneem N, Qaryouti D, Quadri S, Adams HP, Ortega-Gutierrez S, Leira E, Zaheer A. Cytokines, brain proteins, and growth factors in acute stroke patients: A pilot study. Surg Neurol Int. 2021 Jul 27;12:366. doi: 10.25259/SNI_569_2021. eCollection 2021.
- Derived from this study: PubMed 32664088Farooqui M, Ikram A, Suriya S, Saleem S, Quadri SA, Robinson M, Ortega-Gutierrez S, Qeadan F, Leira E, Paul S, Zafar A. Cytokine Registry In Stroke Patients (CRISP): Protocol of a prospective observational study. Medicine (Baltimore). 2020 Jul 10;99(28):e20921. doi: 10.1097/MD.0000000000020921.
- Derived from this study: PubMed 29234571Zafar A, Ikram A, Jillella DV, Kempuraj D, Khan MM, Bushnaq S, Adam H, Ortega-Gutierrez S, Quadri SA, Farooqui M, Zaheer A, Leira EC. Measurement of Elevated IL-37 Levels in Acute Ischemic Brain Injury: A Cross-sectional Pilot Study. Cureus. 2017 Oct 11;9(10):e1767. doi: 10.7759/cureus.1767.
- Cytokines, brain proteins, and growth factors in acute stroke patients: A pilot studyLink provided by the sponsor.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Michel Torbey, MD, MPH study chair
University of New Mexico
Atif Zafar, MD principal investigator
University of New Mexico
Asad Ikram, MD study director
University of New Mexico
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Acute Stroke and Acute Ischemic Stroke, run by University of New Mexico at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 8 Feb 2022. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in the cytokine levels at the 24-hour mark from the baseline levels done at the time of admission for acute stroke. (time frame: 24 Hours). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03297827, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Feb 2022.