Journal of the American Heart Association· 2026Q1
Temporal Dynamics of Complement Activation and Outcome in Patients With Acute Ischemic Stroke
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- 2026year
Short summary
Complement activation, specifically lower levels of complement factor Bb, was associated with unfavorable functional outcomes and moderate-to-severe strokes in acute ischemic stroke patients.
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Key points
- Acute ischemic stroke patients showed broad complement activation compared to controls, with increased C1q, mannose-binding lectin, Bb, C3a, C5a, C5b-9, and decreased factor H.
- Complement factor Bb levels were lower in patients with unfavorable functional outcomes and moderate-to-severe strokes.
- C1q and C3a trajectories differed based on functional outcome.
- C3a trajectories also varied with stroke severity.
- C1q trajectories were influenced by age group and infarct volume.
AI-generated from the title and abstract; the full text is not read.
Abstract
BACKGROUND: Immune-mediated inflammatory responses exacerbate brain injury and affect the prognosis in acute ischemic stroke. METHODS: We characterized longitudinal complement activation after acute ischemic stroke using serial plasma samples from 10 patients and 8 controls. Initial markers of classical (C1q), lectin (mannose-binding lectin), and alternative (complement factor Bb) pathways, as well as regulatory (complement factor H) and downstream markers (C3a, C5a, and C5b-9) were measured by ELISA at 9 time points. RESULTS: Patients with stroke showed broad complement activation, with increased C1q, mannose-binding lectin, complement factor Bb, C3a, C5a, and C5b-9, and reduced complement factor H compared with controls. Complement components showed distinct temporal patterns during follow-up. Complement factor Bb levels were lower in patients with unfavorable functional outcome and in those with moderate-to-severe stroke. C1q and C3a trajectories differed according to functional outcome, whereas C3a trajectories also differed according to stroke severity. C1q trajectories differed according to age group and infarct volume. CONCLUSIONS: These findings suggest dynamic, pathway-specific complement activation after acute ischemic stroke and highlight the need for larger studies to clarify its prognostic and therapeutic relevance.
The authors' abstract, as published at the source. Journal of the American Heart Association, 2026 · DOI ↗
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ImmunologyImmunology and Microbiology