Background: To explore the correlations between homocysteine (Hcy), high mobility group protein B1 (HMGB1), and Toll-like receptor 4 (TLR4) levels and the polarisation of mononuclear macrophages among individuals who were admitted with acute cerebral infarction (ACI). Methods: The case group comprised 214 ACI patients admitted to the hospital between August 2022 and August 2024, whereas the control group comprised 100 healthy individuals who underwent physical examinations during the same period. A comparison was made between the two groups' admission serum Hcy, HMGB1, and TLR4 levels. The polarisation conditions of the mononuclear macrophages in the two groups were compared proportion of M1-type cells, proportion of M2-type cells, M1/M2 ratio, M1-type polarisation markers (interleukin-1b, tumour necrosis factor-a), and M2-type polarisation markers (interleukin-10, transforming growth factor-b). The aim was to investigate the connections between the polarisation of mononuclear macrophages and the levels of Hcy, HMGB1, and TLR4 in ACI patients, as well as the associations between these levels and the prognosis of ACI patients. Serum levels of Hcy, HMGB1, and TLR4 were compared between ACI patients grouped by excellent or poor prognosis. The prognostic efficacy of Hcy, HMGB1, and TLR4 in ACI patients was evaluated using receiver operating characteristic (ROC) curves. Results: Serum Hcy, HMGB1, and TLR4 levels in the case group were considerably higher (P 0.05) than those in the control group. Interleukin-1p and tumour necrosis factor-a levels, the M1/M2 ratio, and the percentage of M1-type cells were all considerably greater (P 0.05) in the case group compared to the control group, although transforming growth factor-b and interleukin-10 levels were significantly lower (P 0.05). Serum Hcy, HMGB1, and TLR4 levels in ACI patients were found to be negatively correlated with interleukin-10 and transforming growth factor-b (P 0.05) and positively correlated with the proportion of M1-type cells, the M1/M2 ratio, and the levels of interleukin-1b and tumour necrosis factor-a (P 0.05), according to the results of the Pearson correlation analysis. Serum Hcy, HMGB1, and TLR4 levels were substantially higher (P 0.05) in the poor prognosis group than in the good prognosis group. With area under the curve (AUC) values of 80.00%, 77.80%, and 0.840 for sensitivity, specificity, and AUC, respectively. The ROC curve analysis showed that the combined prediction of Hcy, HMGB1, and TLR4 levels had a comparatively high efficacy in predicting the prognosis of ACI patients. Conclusions: Patients with ACI had elevated Hcy levels and increased HMGB1 and TLR4 expression in peripheral blood. These levels are anticipated to serve as biomarkers for the clinical diagnosis and treatment of ACI and are strongly correlated with mononuclear macrophage polarisation and patient prognosis.
Gao et al. (Thu,) studied this question.