Clinical Improvement Following Stroke Promptly Reverses Post-stroke Cellular Immune Alterations

Conclusions: SIIA are detectable on admission of acute stroke patients. While it was assumed that post-stroke immunosuppression is rapidly reversed with improvement this is the first data set that shows that improvement actually is associated with a rapid reversal of SIIA demonstrating that SIIA require a constant signal to persist. The observation that HMGB-1 serum concentrations were similar in improved and non-improved cohorts argues against a role for this pro-inflammatory mediator in the maintenance of SIIA. Serum miRNA observed to be regulated in stroke in other publications was counter regulated with improvement in our cohort. Introduction Post-stroke infections, predominantly pneumonia, are associated with increased mortality and impaired neurological outcome. In recent years, it has been clearly shown in both experimental stroke and stroke patients that these infections are closely related to stroke-induced immune alterations (SIIA) of the peripheral immune system (1, 2). SIIA develop within the first hours of ischemic stroke and persist at least for days up to weeks (3–5). Stroke volume and stroke severity on admission as determined by NIHSS are associated with post-stroke infections (6) and patients with transitory ischemic attacks have significantly fewer infectious complications and show a milder immune response after stroke compared to patients with complete stroke (7) and it is likely that patients with initially severe ischemic stroke that impro...
Source: Frontiers in Neurology - Category: Neurology Source Type: research