Plasma S100A1 protein: An effective prognostic biomarker for 3-month clinical outcome in acute ischemic stroke patients

Background: Plasma S100A1 protein is a novel inflammation biomarker associated with acute myocardial infarction and neurodegenerative diseases. This study aimed to investigate the predictive value of S100A1 protein for the three-month prognosis of acute ischemic stroke (AIS) patients and the potential pathophysiological mechanisms of AIS. Methods: A total of 206 people in a stroke center from April 2020 to February 2021 were studied. Clinically relevant data and blood indicators were recorded. The clinical outcome was disability or death at discharge or 90 days (defined as a modified Rankin Scale score of 3-6). The relationship between S100A1 protein, NF-κB p65, and IL-6 and functional outcomes was investigated by binary logistic regression analysis and further assessed by the receiver operating characteristic curve (ROC). The correlation between S100A1, NF-κB p65, and IL-6 was detected by Pearson or Spearman correlation analysis. Results: A total of 206 subjects were enrolled (Age, 67.17±10.74; 40.3% female). Patients with unfavorable outcome showed higher S100A1, NF-κB p65, and IL-6 than those with favorable outcome (S100A1, [252.72±25.15]vs[219.84±23.24], P<0.001; NF-κB p65, [4.45±0.71]vs[3.58±0.66], P<0.001; IL-6, [13.86±1.41]vs[12.18±1.73], P<0.001). In multivariate and ROC curve analysis, higher S100A1 (>227.155) (Area under the curve [AUC], 0.864; odds ratio [OR], 1.093; 95% confidence interval [CI], 1.052- 1.135; P <0.001) and higher NF-κB p65 (>3.685) (AUC, 0.807; OR, 6.416; 95% CI, 1.852- 22.229; P=0.003), higher IL-6 (>12.330) (AUC, 0.767; OR, 2.029; 95% CI, 1.136- 3.624; P=0.017) were independently associated with unfavorable outcome. The combined predictive value of the three indexes was higher than that of a single index. There was a significant statistical correlation between S100A1, NF-κB P65 and IL-6(P<0.001). Conclusion: Higher S100A1 protein may be an independent risk factor for predicting the three-month poor prognosis in AIS patients. This protein may mediate inflammatory response through the NF-κB pathway during the pathogenesis of AIS.