Assessment of nitrosative oxidative stress in patients with middle cerebral artery occlusion

OBJECTIVE: To assess serum levels of nitric oxide and peroxynitrite in patients presenting with cerebral infarction resulting from middle cerebral artery occlusion, at 48 hours from stroke onset.

METHODS: We conducted the study in the Department of Pharmacology and in cooperation with Al-Yarmouk Teaching Hospital and the Department of Medicine, College of Medicine, Al-Mustansiriya University, Baghdad, Iraq from October 2003 to May 2004. Twenty patients presented with neurological deficits of middle cerebral artery occlusion, and we also enrolled 20 healthy individuals to serve as a control group. We obtained venous blood samples from each patient after 48 hours of stroke onset and each healthy individual. We determined the serum level of nitric oxide as well as peroxynitrite.

RESULTS: Serum nitric oxide and peroxynitrite were significantly (p<0.001) higher in patients (103.9 +/- 40.2 umol and 2.7 +/- 0.6 umol) than in healthy individuals (53.3 +/- 20.7 umol and 2.3 +/- 0.2 umol). The formation of peroxynitrite directly correlated with nitric oxide in healthy individuals (r=0.84), and patients (r=0.514).

CONCLUSION: Serum intermediate nitrogen species; nitric oxide and peroxynitrite were significantly increased after 48 hours of stroke onset in patients with middle cerebral artery occlusion. The rate of peroxynitrite formation from nitric oxide was slightly increased.