Neuroinflammatory role of CCL5 and neutrophils in acute ischemic stroke severity

Stroke is the second leading cause of death worldwide and the primary contributor to long-term disability. Its pathogenesis involves a complex inflammatory response, in which C-C motif chemokine ligand 5 (CCL5) plays a dual role through C-C chemokine receptor 5 (CCR5). However, clinical findings regarding CCL5 remain inconsistent. This study aimed to evaluate the association between serum CCL5 levels, absolute neutrophil count (ANC), and platelet count with the severity of acute ischemic stroke, and to explore their potential as predictive biomarkers. An analytical cross-sectional study was conducted at Dr. Wahidin Sudirohusodo General Hospital, Makassar, and affiliated teaching hospitals, enrolling 58 patients with acute ischemic stroke. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS). Serum CCL5 levels, ANC, and platelet count were measured from venous blood samples. Patients with moderate–severe stroke demonstrated significantly higher CCL5 levels and ANC compared to those with mild stroke (p < 0.05), while platelet counts showed no significant difference. Both CCL5 and ANC correlated positively with NIHSS scores, whereas platelet count did not. Receiver operating characteristic analysis indicated moderate discriminative performance. These findings suggest that serum CCL5 may serve as a useful screening biomarker for identifying the severity of acute ischemic stroke. Nevertheless, its diagnostic application should be integrated with clinical and radiological parameters to enhance predictive accuracy.