Systemic immune responses after ischemic stroke: From the center to the periphery

Abstract

Ischemic stroke is a leading cause of disability and death. It imposes a heavy economic burden on individuals, families and society. The mortality rate of ischemic stroke has decreased with the help of thrombolytic drug therapy and intravascular intervention. However, the nerve damage caused by ischemia-reperfusion is long-lasting and followed by multiple organ dysfunction. In this process, the immune responses manifested by systemic inflammatory responses play an important role. It begins with neuroinflammation following ischemic stroke. The large number of inflammatory cells released after activation of immune cells in the lesion area, along with the deactivated neuroendocrine and autonomic nervous systems, link the center with the periphery. With the activation of systemic immunity and the emergence of immunosuppression, peripheral organs become the second “battlefield” of the immune response after ischemic stroke and gradually become dysfunctional and lead to an adverse prognosis. The purpose of this review was to describe the systemic immune responses after ischemic stroke. We hope to provide new ideas for future research and clinical treatments to improve patient outcomes and quality of life.

Systemic inflammation response index predicts 3-month outcome in patients with mild acute ischemic stroke receiving intravenous thrombolysis

“…It has been proved that the IR after AIS is related to the secondary brain damage after infarction ( 20 , 21 ). The inflammatory mediators, cytokines, adhesion molecules, and chemokines released by immune inflammatory cells exacerbate tissue damage.…”

Pan-Immune-Inflammatory Value Predicts the 3 Months Outcome in Acute Ischemic Stroke Patients after Intravenous Thrombolysis

“…After cerebral ischemia injury, the damage-associated molecular patterns (DAMPs) released by necrotic cells activate resident immune cells in the central nervous system, such as microglia and astrocytes, which subsequently attract peripheral immune cells to activate adaptive immune responses [ 13 ]. The activated immune system along with the deactivated neuroendocrine and autonomic nervous systems, link the center with the periphery, leading to the systemic immune inflammatory response [ 14 ]. There is increasing evidence to suggest that the global immune inflammatory response can affect the clinical outcomes of stroke [ 15 , 16 ].…”

Mechanisms of immune response and cell death in ischemic stroke and their regulation by natural compounds

“…In the acute phase of IS, T cells chiefly react in an antigen-independent manner and are closely related to the development of the infarct volume. After 3-7 days, the T cell response gradually transforms into antigen-dependent antigen recognition ( 92 ). Brain-derived antigens are recognized by T cell receptors (TCRs) on the surface of naïve T cells.…”