{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:07:31Z","timestamp":1785402451458,"version":"3.56.0"},"reference-count":21,"publisher":"IMR Press","issue":"7","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br. J. Hosp. Med. (Lond)"],"abstract":"<jats:p>Aims\/Background:Patients with ischemic stroke are prone to developing respiratory tract infections, which can seriously affect prognosis. The objective of this study was to assess the association of the serum levels of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-\u03b1), and hypoxia-inducible factor-1 alpha (HIF-1\u03b1) with the occurrence of respiratory tract infection, and to determine whether these biomarkers are independently associated with infection risk.Methods:A total of 140 patients with ischemic stroke admitted to The Fifth People\u2019s Hospital of Jinan between January 2024 and September 2025 were enrolled. Based on the presence or absence of respiratory tract infection, patients were divided into an infection group (n = 41) and a non-infection group (n = 99). Blood samples were collected within 24 hours after admission. Serum IL-6, TNF-\u03b1, and HIF-1\u03b1 levels were measured using enzyme-linked immunosorbent assay (ELISA). Baseline characteristics were compared between the two groups. Point-biserial correlation and univariate logistic regression were used to assess the relationships between inflammatory markers (IL-6, TNF-\u03b1, HIF-1\u03b1) and respiratory tract infection, followed by multivariate logistic regression to identify independent influencing factors.Results:There were no significant differences between the two groups in terms of age, gender, body mass index, smoking and drinking history, hypertension, diabetes, coronary heart disease, hyperlipidemia, infarction site, National Institutes of Health Stroke Scale (NIHSS) score, Glasgow Coma Scale (GCS) score, mean respiratory rate, or mean oxygen saturation (p &gt; 0.05). Serum levels of IL-6, TNF-\u03b1, and HIF-1\u03b1 were significantly higher in the infection group than in the non-infection group (p &lt; 0.001). Point-biserial correlation analysis revealed that IL-6, TNF-\u03b1, and HIF-1\u03b1 were positively correlated with respiratory tract infection (r = 0.695, 0.738, and 0.655, respectively; p &lt; 0.001). Univariate logistic regression indicated that all three biomarkers were influencing factors of respiratory tract infection (p &lt; 0.001), and multivariate logistic regression confirmed them as independent influencing factors (p &lt; 0.05).Conclusion:Elevated serum levels of IL-6, TNF-\u03b1, and HIF-1\u03b1 are significantly associated with respiratory tract infection in patients with ischemic stroke. However, this association does not imply a causal relationship, and the observed increases in these inflammatory markers may reflect a consequence of infection rather than independent risk factors. Early monitoring of these biomarkers may help identify patients with increased risk of developing infection and facilitate timely clinical assessment and intervention to improve outcomes.<\/jats:p>","DOI":"10.31083\/bjhm56310","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T07:59:43Z","timestamp":1785398383000},"source":"Crossref","is-referenced-by-count":0,"title":["Association of Serum IL-6, TNF-\u03b1, and HIF-1\u03b1 Levels With Respiratory Tract Infection in Patients With Ischemic Stroke"],"prefix":"10.31083","volume":"87","author":[{"given":"Wenwen","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Geriatric Respiratory Medicine, The Fifth People\u2019s Hospital of Jinan, 250022 Jinan, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9130-7655","authenticated-orcid":true,"given":"Qing","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Neurology II, The Fifth People\u2019s Hospital of Jinan, 250022 Jinan, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16242","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Ho JP, Powers WJ. Contemporary Management of Acute Ischemic Stroke. Annual Review of Medicine. 2025; 76: 417\u2013429.","DOI":"10.1146\/annurev-med-050823-094312"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Feske SK. Ischemic Stroke. The American Journal of Medicine. 2021; 134: 1457\u20131464.","DOI":"10.1016\/j.amjmed.2021.07.027"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Bangad A, Abbasi M, de Havenon A. Secondary Ischemic Stroke Prevention. Neurotherapeutics. 2023; 20: 721\u2013731.","DOI":"10.1007\/s13311-023-01352-w"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Berge E, Whiteley W, Audebert H, De Marchis GM, Fonseca AC, Padiglioni C, et al. European Stroke Organisation (ESO) guidelines on intravenous thrombolysis for acute ischaemic stroke. European Stroke Journal. 2021; 6: I\u2013LXII.","DOI":"10.1177\/2396987321989865"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Turc G, Bhogal P, Fischer U, Khatri P, Lobotesis K, Mazighi M, et al. European Stroke Organisation (ESO) - European Society for Minimally Invasive Neurological Therapy (ESMINT) Guidelines on Mechanical Thrombectomy in Acute Ischemic Stroke. Journal of Neurointerventional Surgery. 2023; 15: e8.","DOI":"10.1136\/neurintsurg-2018-014569"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Tsivgoulis G, Katsanos AH, Sandset EC, Turc G, Nguyen TN, Bivard A, et al. Thrombolysis for acute ischaemic stroke: current status and future perspectives. The Lancet. Neurology. 2023; 22: 418\u2013429.","DOI":"10.1016\/S1474-4422(22)00519-1"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Endres M, Moro MA, Nolte CH, Dames C, Buckwalter MS, Meisel A. Immune Pathways in Etiology, Acute Phase, and Chronic Sequelae of Ischemic Stroke. Circulation Research. 2022; 130: 1167\u20131186.","DOI":"10.1161\/CIRCRESAHA.121.319994"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Westendorp WF, Dames C, Nederkoorn PJ, Meisel A. Immunodepression, Infections, and Functional Outcome in Ischemic Stroke. Stroke. 2022; 53: 1438\u20131448.","DOI":"10.1161\/STROKEAHA.122.038867"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Li D, Liu Y, Jia Y, Yu J, Li F, Li H, et al. Association between malnutrition and stroke-associated pneumonia in patients with ischemic stroke. BMC Neurology. 2023; 23: 290.","DOI":"10.1186\/s12883-023-03340-1"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Li D, Yuan L, Wang T, Rong Y, Li C, You M, et al. Risk factors for stroke-related pneumonia in patients with ischaemic stroke: A systematic evaluation and meta-analysis. Clinical Neurology and Neurosurgery. 2024; 246: 108593.","DOI":"10.1016\/j.clineuro.2024.108593"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"de Mello MEL, Andreghetto S, de Aguiar da Costa M, Linden de Rezende V, Gon\u00e7alves CL, Giustina AD, et al. The risk of stroke-related pneumonia: a systematic review of peripheral immunodepression markers. Expert Review of Respiratory Medicine. 2025; 19: 449\u2013459.","DOI":"10.1080\/17476348.2025.2481956"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Li J, Luo H, Chen Y, Wu B, Han M, Jia W, et al. Comparison of the Predictive Value of Inflammatory Biomarkers for the Risk of Stroke-Associated Pneumonia in Patients with Acute Ischemic Stroke. Clinical Interventions in Aging. 2023; 18: 1477\u20131490.","DOI":"10.2147\/CIA.S425393"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"Kochetov AG, Lyang OV, Zhirova IA, Ivoylov OO, Politidis RR, Novozhenova YV. Proinflammatory laboratory predictors of pneumonia in ischemic stroke patients: prospective study. Terapevticheskii Arkhiv. 2022; 94: 491\u2013496.  (In Russian)","DOI":"10.26442\/00403660.2022.04.201460"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"He Q, Ma Y, Liu J, Zhang D, Ren J, Zhao R, et al. Biological Functions and Regulatory Mechanisms of Hypoxia-Inducible Factor-1\u03b1 in Ischemic Stroke. Frontiers in Immunology. 2021; 12: 801985.","DOI":"10.3389\/fimmu.2021.801985"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"Mengel A, Ulm L, Hotter B, Harms H, Piper SK, Grittner U, et al. Biomarkers of immune capacity, infection and inflammation are associated with poor outcome and mortality after stroke - the PREDICT study. BMC Neurology. 2019; 19: 148.","DOI":"10.1186\/s12883-019-1375-6"},{"key":"ref16","doi-asserted-by":"publisher","unstructured":"Liu L, Li Z, Zhou H, Duan W, Huo X, Xu W, et al. Chinese Stroke Association guidelines for clinical management of ischaemic cerebrovascular diseases: executive summary and 2023 update. Stroke and Vascular Neurology. 2023; 8: e3.","DOI":"10.1136\/svn-2023-002998"},{"key":"ref17","doi-asserted-by":"publisher","unstructured":"Zhu H, Hu S, Li Y, Sun Y, Xiong X, Hu X, et al. Interleukins and Ischemic Stroke. Frontiers in Immunology. 2022; 13: 828447.","DOI":"10.3389\/fimmu.2022.828447"},{"key":"ref18","doi-asserted-by":"publisher","unstructured":"Pawluk H, Wo\u017aniak A, Tafelska-Kaczmarek A, Kosinska A, Pawluk M, Sergot K, et al. The Role of IL-6 in Ischemic Stroke. Biomolecules. 2025; 15: 470.","DOI":"10.3390\/biom15040470"},{"key":"ref19","doi-asserted-by":"publisher","unstructured":"Zhang M, Shi X, Zhang B, Zhang Y, Chen Y, You D, et al. Predictive value of cytokines combined with human neutrophil lipocalinin acute ischemic stroke-associated pneumonia. BMC Neurology. 2024; 24: 30.","DOI":"10.1186\/s12883-023-03488-w"},{"key":"ref20","doi-asserted-by":"publisher","unstructured":"Wang H, Deng QW, Peng AN, Xing FL, Zuo L, Li S, et al. \u03b2-arrestin2 functions as a key regulator in the sympathetic-triggered immunodepression after stroke. Journal of Neuroinflammation. 2018; 15: 102.","DOI":"10.1186\/s12974-018-1142-4"},{"key":"ref21","doi-asserted-by":"publisher","unstructured":"Vatte S, Ugale R. HIF-1, an important regulator in potential new therapeutic approaches to ischemic stroke. Neurochemistry International. 2023; 170: 105605.","DOI":"10.1016\/j.neuint.2023.105605"}],"container-title":["British Journal of Hospital Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.imrpress.com\/journal\/BJHM\/87\/7\/10.31083\/BJHM56310","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T07:59:49Z","timestamp":1785398389000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.imrpress.com\/journal\/BJHM\/87\/7\/10.31083\/BJHM56310"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,24]]},"references-count":21,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026]]}},"alternative-id":["S1750-8460(26)03357-0"],"URL":"https:\/\/doi.org\/10.31083\/bjhm56310","relation":{},"ISSN":["1750-8460","1759-7390"],"issn-type":[{"value":"1750-8460","type":"print"},{"value":"1759-7390","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,24]]},"article-number":"56310"}}