Frequencies of circulating B- and T-lymphocytes as indicators for stroke outcomes

Abstract

BackgroundStroke has high mortality and morbidity. Biomarkers are required for to predict stroke outcomes, which could help clinicians to provide rationale approaches for patient management. The dynamic changes in circulating immune cells have been reported in stroke patients and animal models of stroke.AimThe aim of this study was to explore biomarkers to predict stroke outcomes by investigating the relationship between the frequencies of circulating immune cells and stroke outcomes.MethodsIn all, 50 acute ischemic stroke (AIS) patients were enrolled. Their blood samples were collected upon hospital admission and on day 1 and day 7 after stroke, and the leukocyte subsets were analyzed by flow cytometry. The dynamic changes in some types of immune cells in the AIS course and their correlation with clinical parameters were analyzed. Blood samples from 123 age- and gender-matched healthy subjects were used as controls.ResultsThe proportions of T-lymphocytes and NK cells in stroke patients were significantly lower than in healthy controls. The frequencies of B- and T-lymphocytes were negatively correlated with stroke severity at onset, including neurological deficits as assessed by National Institutes of Health Stroke Scale (NIHSS), and infarct volume as measured by the diffusion-weighted images (DWIs) of magnetic resonance (MR). Logistic regression analysis showed that modified Rankin scale (mRs) scores, a score system for the long-term neurological dysfunctions, were negatively correlated with the percentage of B-lymphocytes at stroke onset.ConclusionThe proportions of B- and T-lymphocytes are associated with neurological outcomes of stroke patients and might be used as an indicator for severity and prognosis of ischemic stroke.

Dynamic changes of peripheral blood lymphocyte subsets in acute ischemic stroke and prognostic value

“…The reduction in number and functions of circulating lymphocytes was also associated with the lower mortality and better outcome of experimental stroke (Chu et al., 2014; Hurn et al., 2007; Schwartz & Moalem, 2001). However, clinical research on this issue has yielded conflicting results (Noh et al., 2018; Vogelgesang et al., 2008; Wang et al., 2017; Yan et al., 2009). Some research has indicated that a profound infiltration of inflammatory cells (monocytes, macrophages, B lymphocytes, Ts cells, and NK cells) occurs in the brain early after focal ischemia (3 hr after stroke), especially without reperfusion(Gendron et al., 2002), while others showed that the percentages of activated T cells and regulatory T cells were significantly increased in patients with ischemic stroke compared to healthy subjects(Yan et al., 2009).…”

Early increased neutrophil-to-lymphocyte ratio is associated with poor 3-month outcomes in spontaneous intracerebral hemorrhage

“…Stroke-induced immunodepression may contribute to the decrease in peripheral lymphocytes and reduce inflammatory-mediated cerebral damage by attenuating over activation of the inflammatory cascade. Therefore, immunodepression post-stroke inversely increases susceptibility to infection and is detrimental to clinical outcomes [36, 37].…”

Systemic inflammation in hemorrhagic strokes – A novel neurological sign and therapeutic target?

“…9,90 The observation of acute lymphopenia and the association between lymphopenia, initial stroke severity, subsequent infection risk, and poor outcome are consistent across ischemic stroke and ICH. 9,90,102–104…”

“…of acute lymphopenia and the association between lymphopenia, initial stroke severity, subsequent infection risk, and poor outcome are consistent across ischemic stroke and ICH. 9,90,[102][103][104] In SAH, few studies reported on changes in lymphocyte subpopulation. They consistently demonstrated significant decrease in circulating T lymphocytes during acute phase SAH.…”