Acute cerebral infarction patients' 3-month mortality predicted by peripheral tumor necrosis factor alpha-induced protein 3 mRNA level

Abstract Background Tumor necrosis factor-induced protein 3 (A20) is a novel negative regulator of immunological homeostasis. This research aimed to determine whether A20 mRNA in peripheral blood mononuclear cells (PBMCs) could be used to predict 3-month functional outcome and mortality in individuals with acute cerebral infarction (ACI). Methods There were 50 healthy controls and 182 patients with ACI in this study. Real-time quantitative polymerase chain reaction was performed to detect the A20 mRNA expression levels in PBMCs from ACI patients and healthy controls.We also recorded the medical history, score of National Institutes of Health Stroke Scale score on the first day of disease onset (NIHSS1), cranial magnetic resonance imaging findings, and hematological examination index. On day 90 after disease onset, the prognosis was evaluated using a modified Rankin scale. Results In comparison to healthy controls, the median A20 mRNA levels in PBMCs of ACI patients were considerably greater (P < 0.001). A20 mRNA expression levels in PBMCs were negatively correlated with lesion volume (r = -0.1678, P < 0.05) and NIHSS1 score (r = -0.2897, P < 0.0001). A20 mRNA expression levels were substantially greater in the survivor group and the groups with favorable outcomes, respectively compared to those in the non-survivor group (P < 0.005) and the groups with unfavorable outcome (P < 0.05). Conclusion A20 mRNA is involved in the immune response in ACI and might be a potential biomarker of ACI-related mortality.