무증상 뇌경색 환자에서 MMP-9, MIF 감소에 따른 Cilostazol의 항염증효과 분석

Abstract

Background and purpose: Silent brain infarcts (SBIs) are cerebral infarcts seen on brain computed tomography (CT) or magnetic resonance imaging (MRI) in the absence of any clinical symptoms of stroke. In a previous study, cilostazol was shown to prevent the appearance or progression of SBIs. The present study aimed to evaluate the anti-inflammatory effect of cilostazol in patients with SBIs by serially measuring inflammation- and angiogenesis-associated biomarkers such as matrix metalloproteinase-9 (MMP-9), macrophage migration inhibitory factor (MIF), visceral fat–derived adipokine (visfatin), C-X-C motif ligand 12 (CXCL12), and vascular endothelial growth factor (VEGF). Methods: We consecutively enrolled 52 patients with SBIs. SBIs were interpreted by two neuroradiologists and two neurologists. MMP-9, MIF, visfatin, CXCL12, and VEGF were measured in fasting blood samples from these 52 patients and 10 healthy volunteers at baseline and after taking cilostazol (200 mg/day) or aspirin (100 mg/day) for 1 week and for 3 months. Results: Serum MMP-9 was higher in patients with SBIs than in healthy controls at baseline (p < 0.05), and levels of MMP-9 and MIF decreased after taking cilostazol for 3 months (p < 0.01). MMP-9 levels were also lower at 1 week in the cilostazol group (p < 0.05). Visfatin was lower than baseline after taking aspirin for 3 months (p < 0.01). Cilostazol and aspirin had no significant effect on the other inflammatory biomarkers such as CXCL12 and VEGF. Conclusions: Cilostazol decreases the inflammatory biomarkers MMP-9 and MIF and may have anti-inflammatory effects in subjects with SBIs.