Common peripheral inflammatory diseases: an underestimated stroke risk factor

Study code
DAA160

Lead researcher
Dr Kieron South

Study type
Data only

Institution or company
University of Manchester

Researcher type
Academic

Speciality area
Stroke, Gastroenterology, Musculoskeletal Disorders, Haematology

Summary

Approximately a third of all stokes; and as many as half of those occurring in adults aged under 49 years of age, cannot be explained by considering common causes or risk factors. Inflammatory diseases of the peripheral organs (e.g. rheumatoid arthritis and inflammatory bowel disease), which affect around 10% of the UK population, may represent an under-researched but clinically relevant stroke risk factor.

Our hypothesis is that these pathologies may cause an increase in stroke incidence and/or severity through von Willebrand factor (VWF)-driven systemic thrombo-inflammation, similar to that observed during infection (e.g. bacterial pneumonia, COVID-19 etc).

We have devised a programme of work focussed on epidemiological analysis, to define the potential link between inflammatory disease and incident stroke, and analysis of patient samples to substantiate a possible causal role of VWF in this context. Establishing a causal mechanism linking inflammatory disease and stroke would provide rationale for prospective studies of these patient populations providing a meaningful contribution to the prevention/treatment of stroke and benefit to patients.

Potential patient benefit:

Although not a novel concept, the precise role of peripheral inflammation in the incidence of ischaemic stroke, its significance in the clinical setting and its targeting as a stroke prevention strategy are all under-researched. These analyses would give a strong rationale for future prospective studies of inflammatory disease patient populations and randomised controlled trials of anti-inflammatory approaches for primary and secondary stroke prevention.