Plasma Resolvin D2 to Leukotriene B(4) Ratio Is Reduced in Diabetic Patients with Ischemic Stroke and Related to Prognosis

BACKGROUND: Diabetes mellitus (DM) aggravates symptoms and prognosis of acute ischemic stroke (AIS), and inflammation plays an important role therein. Resolvin D2 (RvD2) is one of the specialized pro-resolving mediators (SPMs), while leukotriene B(4) (LTB(4)) is a classic proinflammatory mediator. The ratio of RvD2 to LTB(4) is an index of pro-resolving/proinflammatory balance. We aim to explore the role of RvD2/LTB(4) ratio in ischemic stroke complicated with DM. METHODS: The plasma levels of RvD2 and LTB(4) were analyzed by enzyme immunoassay in stroke patients with DM (DM + AIS group) or without DM (nonDM+AIS group). Patients were followed up at 90 days after stroke onset, and modified Rankin Score (mRS) was assessed. The association of RvD2/LTB(4) ratio with stroke severity and prognosis was also analyzed. RESULTS: The plasma levels of RvD2 were positively correlated to LTB(4). The RvD2/LTB(4) ratio in DM + AIS group was lower than that in the nonDM+AIS group. No correlation was found between the RvD2/LTB(4) ratio and infarct size or NIHSS score. The RvD2/LTB(4) ratio at baseline was significantly lower in the poor prognosis group (mRS ≥ 3) than that in the good prognosis group (mRS ≤ 2). CONCLUSIONS: Our study indicated that the balance between pro-resolving and proinflammatory mediators was impaired by diabetes in ischemic stroke. The RvD2/LTB(4) ratio may serve as a biomarker of prognosis for ischemic stroke.