High levels of COX-2 gene expression in peripheral blood of cardioembolic and atherothrombotic stroke patients

Aim: To determine if COX-2 and TLR4 gene expression in atherothrombotic strokes represents a marker of atherosclerotic plaque destabilization and rupture, or it rather is related to the inflammatory response caused by stroke itself. Secondly, to determine if COX-2 and TLR4 gene expression could be specific for stroke subtype. Methods: Total RNA was extracted from peripheral blood samples from atherosclerotic (N=30) and cardioembolic stroke (N=25) patients, and controls (N=27). Gene expression was analysed by real time RT-PCR. Results: Expression of COX-2 gene was increased in cardioembolic compared to atherothrombotic stroke patients or healthy controls (p<0.0001). TLR4 expression was higher cardioembolic stroke patients compared to controls (p=0.0001). Conclusions: Cardioembolic show higher levels of COX-2 expression compared to atherothrombotic stroke patients independent of clinical severity. Additional studies are warrant to establish if high level of COX-2 gene expression could be a marker of cardioembolic stroke.