Chronic Systemic Immune Dysfunction in African-Americans with Small Vessel-Type Ischemic Stroke

Abstract

Background The incidence of small vessel-type (lacunar) ischemic strokes is greater in African-Americans compared to whites. The chronic inflammatory changes that result from lacunar stroke are poorly understood. To elucidate these changes, we measured serum inflammatory and thrombotic biomarkers in African-Americans at least 6 weeks post-stroke compared to control individuals. Methods Cases were African-Americans with lacunar stroke (n=30), and controls were age-matched African-Americans with no history of stroke or other major neurologic disease (n=37). Blood was obtained >6 weeks post-stroke and analyzed for inflammatory biomarkers. Freshly isolated peripheral blood mononuclear cells were stimulated with lipopolysaccharide (LPS) to assess immune responsiveness in a subset of cases (n=5) and controls (n=4). Results After adjustment for covariates, the pro-inflammatory biomarkers, soluble vascular cadherin adhesion molecule-1 (sVCAM-1) and thrombin anti-thrombin (TAT), were independently associated with lacunar stroke. Immune responsiveness to LPS challenge was abnormal in cases compared to controls. Conclusions African-Americans with lacunar stroke had elevated blood levels of VCAM-1 and TAT and an abnormal response to acute immune challenge >6 weeks post-stroke, suggesting a chronically compromised systemic inflammatory response.

The novel Nrf2 activator CDDO‐EA attenuates cerebral ischemic injury by promoting microglia/macrophage polarization toward M2 phenotype in mice

“…Rapid restoration of blood supply through surgical treatment and intravenous thrombolysis is an effective treatment, although this also can lead to cerebral ischemia‐reperfusion injury 2 . The pathophysiological mechanism of cerebral ischemia‐reperfusion injury is complex, involving cell apoptosis, oxidative stress injury, and inflammatory response 3,4 . When ischemic stroke occurs, local microglia/macrophages are rapidly activated, mobilize to the injury site, and initiate the release of effectors and recruitment of peripheral inflammatory cells 3,4 .…”

A novel neurotherapeutic for multiple sclerosis, ischemic injury, methamphetamine addiction, and traumatic brain injury

“…Post-stroke inflammation includes a rapid activation of microglia followed by the infiltration of peripheral inflammatory cells, including neutrophils, T cells, B cells, and macrophages [64–67]. The influx of these immune cells is known to exacerbate brain injury and deteriorate stroke outcomes [68, 69].…”

Number of Pre-Existing Comorbidities and Prognosis of COVID-19: A Retrospective Cohort Study

“…Recent studies suggested that viral susceptibility in patients with NCDs may be associated with a low immune response [15,16]. Changes in immune system activity have been identi ed as a hallmark feature of many NCDs, including type 2 diabetes mellitus, atherosclerosis and cancer [17,18]. Patients with NCDs often get broken homeostatic immune response and decrease in regulatory T cells [18][19][20].…”

“…Changes in immune system activity have been identi ed as a hallmark feature of many NCDs, including type 2 diabetes mellitus, atherosclerosis and cancer [17,18]. Patients with NCDs often get broken homeostatic immune response and decrease in regulatory T cells [18][19][20]. So immunological response might not be generated such effectively to defend attack of virus in patients with NCDs compared to normal population.…”