Oxidative and nitrosative stress in acute ischaemic stroke

Background Increased nitric oxide (NO) production may result in further brain damage via nitric oxide synthase uncoupling in patients with acute ischaemic stroke by increasing free radical formation and oxidative stress. In this connection, we measured nitrite and nitrate (NO metabolites), ischaemia-modified albumin (IMA) and thiobarbituric acid-reactive substances (TBARS) in patients with ischaemic stroke. Methods We studied 41 patients with ischaemic stroke (22 men and 19 women, aged 65 +/- 13 years) and 37 age- and sex-matched controls (22 men and 15 women, aged 65+/-8 years). Blood samples were drawn within the first 24 h from the onset of symptoms in the patient group. Fasting morning samples were used in the control group. Concentrations of nitrite and nitrate were determined by Griess reagent; concentrations of IMA were determined by the albumin cobalt-binding test; and concentrations of TBARS were determined colorimetrically by thiobarbituric acid. Results Nitrate, IMA and TBARS concentrations were significantly increased compared with controls (P<0.005, P<0.001, and P=0.01, respectively). Conclusions Patients with acute ischaemic stroke exhibit abnormalities in a range of markers of increased nitrosative and oxidative stress. These abnormalities may contribute to greater brain damage in patients with acute ischaemic stress.