Increasing plasma neopterin and persistent plasma endothelin during follow-up after acute cerebral ischemia

Release of inflammatory mediators from leukocytes and endothelial release o f vasoactive factors are both important in the pathogenesis of atherosclero sis. To evaluate the concentrations of a specific marker for macrophage act ivation, neopterin, and the potent endothelial derived vasoconstrictive pep tide endothelin-l (ET-1), during the acute and chronic stages of cerebral i schemia, plasma concentrations of neopterin and ET-1 were measured in 59 pa tients with acute cerebral infarction or transient ischemic attack (median age 73 years, range 43-93, 27 men) and after a 1-year follow-up in 57/59 (9 7%) of patients. Plasma neopterin was higher at follow-up (6.3 nmol/L [3.7- 21.6] vs 5.6 nmol/L [3.5-17.2]; p < 0.05) than at the acute stage, whereas the plasma ET-1 concentration was unchanged. Plasma concentrations of both neopterin and ET-1 correlated directly with age both in the acute stage (r = 0.42 and r = 0.35, respectively; p < 0.01) and after follow-up (r = 0.34; p < 0.05 and r = 0.27; p = 0.05, respectively). In conclusion, plasma neop terin increased after acute cerebral ischemia, indicating chronic inflammat ory activity and continuous macrophage activation in ischemic cerebrovascul ar diseases.