Immunological observations on patients with acute cerebral vascular disease

Członkowska, Anna; Cyrta, Barbara; Korlak, J

doi:10.1016/0022-510x(79)90024-8

Cited by 72 publications

(46 citation statements)

References 10 publications

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“…88 In patients, reported defects in immune function after stroke include reduced peripheral blood lymphocyte counts and impaired T-and natural killer cell activity, and reduced mitogen-induced cytokine production and proliferation in vitro. 89,90 One small study 91 found a higher incidence of severe infections after left hemisphere infarctions although in the larger ESPIAS trial the incidence of infection was not lateralized, 48 in agreement with observations in ischemic rats. 92 In this clinical trial, levofloxacin was not able to prevent the incidence of infection in patients with nonseptic acute stroke.…”

Section: Immunological Changes After Acute Brain Ischemia: Experimentsupporting

confidence: 69%

Infection After Acute Ischemic Stroke

Chamorro

Urra²,

Planas³

2007

Stroke

346

161

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Background and Purpose-Infection after experimental focal ischemia may result from brain-induced immunodepression, but it is unsettled whether a similar syndrome occurs in human stroke. Summary of Review-Many patients develop infections shortly after acute stroke regardless of optimal management.Mortality is higher in these patients and the severity of stroke is the strongest determinant of the infectious risk. However, it is controversial whether infections promote neurological worsening or alternatively represent a marker of severe disease. The brain and the immune system are functionally linked through neural and humoral pathways, and decreased immune competence with higher incidence of infections has been demonstrated in several acute neurological conditions. In experimental brain ischemia, infections are associated with the activation of the autonomous nervous system and neuroendocrine pathways, which increase the strength of anti-inflammatory signals. A strong cytokinemediated anti-inflammatory response was recently observed in stroke patients at higher risk of infection, although infection could not demonstrate an independent association with the progression of the symptoms. Conclusions-The appearance of infection in patients with acute stroke obeys in part to immunological mechanisms triggered by acute brain injury. An excessive anti-inflammatory response is a key facilitating factor for the development of infection, and it is likely that this immunological response represents an adaptive mechanism to brain ischemia. Contrarily, it is unclear whether infection contributes independently to poor outcome in human stroke. Overall, a better understanding of the cross-talk between the brain and the immune system might lead to more effective therapies in patients with acute stroke.

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Section: Immunological Changes After Acute Brain Ischemia: Experimentsupporting

confidence: 69%

Infection After Acute Ischemic Stroke

Chamorro

Urra²,

Planas³

2007

Stroke

346

161

View full text Add to dashboard Cite

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“…Reductions in both lymphocyte number and function are observed. 144 Similarly, even greater risk of infection was observed when therapies with even subtle effects on immune function (such as hypothermia) were used in the treatment of cerebral ischemia. 145 Other, less obvious effects of immune modulation could also be influential.…”

Section: Beneficial Effects Of Polymorphonuclear Leukocytes and Monocmentioning

confidence: 99%

“…An increased incidence of nosocomial infection is the most obvious risk and has been reported by numerous investigators. 143 ' 144 In addition, cell-mediated immunity is depressed during the first week after stroke. Reductions in both lymphocyte number and function are observed.…”

Section: Beneficial Effects Of Polymorphonuclear Leukocytes and Monocmentioning

confidence: 99%

Polymorphonuclear leukocytes and monocytes/macrophages in the pathogenesis of cerebral ischemia and stroke.

Kochanek

Hallenbeck

1992

Stroke

561

310

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Background:The extent to which polymorphonuclear leukocytes and monocytes/macrophages contribute to the pathobiology of cerebral ischemia and stroke is an issue of long-standing contradiction and controversy. Recent developments in the ability to selectively modify leukocyte adhesion with antiadhesion antibodies and the potential clinical application of this therapeutic approach have spurred a resurgence of experimental studies examining the role of leukocytes in cerebral ischemia and stroke.Summary of Review: We review studies examining leukocyte accumulation, initiation of thrombosis, and exacerbation of ischemic brain injury in stroke, and we examine other proposed contributions of leukocytes to cerebrovascular pathophysiology.Conclusions: The importance of specific characteristics of a given ischemia model and of underlying stroke risk factors in determining the degree of leukocyte involvement and effectiveness of therapies directed against these cells is discussed. (Stroke 1992;23:1367-1379)

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“…This immune suppression is referred to as stroke-induced immunodeficiency syndrome (SIDS). Experimental and clinical studies have demonstrated that SIDS occurs within hours after stroke onset and can last for up to several weeks [31][32][33] . The infarct volume determines the extent of immunodepression 34) .…”

Section: Discussionmentioning

confidence: 99%

Response of Salivary Stress Markers in Conscious and Unconscious Patients with Acute Ischemic Stroke

Shinohara

Shiraishi

Hasegawa

2016

J St. Marianna Univ

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Background and Purpose: Several salivary markers have been utilized to evaluate acute or chronic psychological stress in various conditions. However, the clinical utility of these biomarkers in acute stroke patients remains uncertain. The aim of this study was to investigate changes in salivary stress markers related to acute stroke, both in conscious and unconscious patients, to assess the feasibility of using salivary stress markers in acute stroke patients. Subjects and Methods: A total of 27 patients with acute ischemic stroke (AIS) as shown on diffusion magnetic resonance imaging (MRI) (mean age, 67.7 ± 12.9 years; 19 males, 70.4%) and 11 control subjects were studied. Saliva was collected from patients with AIS within 24 hours after onset (Day-1), followed by serial collection at Day-4 and Day-7 using a polymer roll saturation method. Salivary concentrations of immunoglobulin A (IgA), cortisol, alpha-amylase, and dehydroepiandrosterone (DHEA) were measured by the enzyme-linked immunosorbent assay. The patients were divided into two groups based on their level of consciousness as evaluated by the National Institutes of Health Stroke Scale (NIHSS) on admission: the alert group (n=20) and the unconscious group (n=7). Motor activity on Day-1 was classified into three categories: in bed, sitting out of bed, and higher motor activity. A multiple linear regression model was used to determine independent factors associated with changes in salivary stress markers. Results: Salivary IgA and cortisol in patients with AIS at Day-1 were significantly higher than in controls (p=0.004 in IgA; p=0.002 in cortisol), and salivary amylase at Day-1 was significantly lower (p=0.049). Salivary IgA was significantly correlated with the NIHSS score (r=0.534, p=0.004) and with initial infarct volume as determined by diffusion MRI (r=0.606, p=0.001). There were no significant serial changes in any of the salivary stress markers. Multiple linear regression analyses demonstrated that motor activity levels in patients without consciousness disturbance was significantly associated with salivary IgA levels. Conclusions:This exploratory study demonstrated the potential utility of salivary IgA in acute ischemic stroke patients. Further studies are warranted to explore the relationship between salivary IgA and the impact of psychological stress on acute ischemic stroke patients.

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Immunological observations on patients with acute cerebral vascular disease

Cited by 72 publications

References 10 publications

Infection After Acute Ischemic Stroke

Infection After Acute Ischemic Stroke

Polymorphonuclear leukocytes and monocytes/macrophages in the pathogenesis of cerebral ischemia and stroke.

Response of Salivary Stress Markers in Conscious and Unconscious Patients with Acute Ischemic Stroke

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