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Stroke-induced immunosuppression: implications for the prevention and prediction of post-stroke infections.
- Source :
-
Journal of neuroinflammation [J Neuroinflammation] 2021 Jun 06; Vol. 18 (1), pp. 127. Date of Electronic Publication: 2021 Jun 06. - Publication Year :
- 2021
-
Abstract
- Stroke produces a powerful inflammatory cascade in the brain, but also a suppression of the peripheral immune system, which is also called stroke-induced immunosuppression (SIIS). The main processes that lead to SIIS are a shift from a lymphocyte phenotype T-helper (Th) 1 to a Th2 phenotype, a decrease of the lymphocyte counts and NK cells in the blood and spleen, and an impairment of the defense mechanisms of neutrophils and monocytes. The direct clinical consequence of SIIS in stroke patients is an increased susceptibility to stroke-associated infections, which is enhanced by clinical factors like dysphagia. Among these infections, stroke-associated pneumonia (SAP) is the one that accounts for the highest impact on stroke outcome, so research is focused on its early diagnosis and prevention. Biomarkers indicating modifications in SIIS pathways could have an important role in the early prediction of SAP, but currently, there are no individual biomarkers or panels of biomarkers that are accurate enough to be translated to clinical practice. Similarly, there is still no efficient therapy to prevent the onset of SAP, and clinical trials testing prophylactic antibiotic treatment and β-blockers have failed. However, local immunomodulation could open up a new research opportunity to find a preventive therapy for SAP. Recent studies have focused on the pulmonary immune changes that could be caused by stroke similarly to other acquired brain injuries. Some of the traits observed in animal models of stroke include lung edema and inflammation, as well as inflammation of the bronchoalveolar lavage fluid.
- Subjects :
- Animals
Biomarkers
Cytokines
Humans
Infections immunology
Inflammation etiology
Inflammation immunology
Lung immunology
Lung pathology
Lymphocytes immunology
Lymphocytes pathology
Monocytes immunology
Monocytes pathology
Neutrophils immunology
Neutrophils pathology
Pneumonia diagnosis
Immunosuppression Therapy
Infections complications
Infections diagnosis
Pneumonia complications
Pneumonia prevention & control
Stroke complications
Stroke immunology
Subjects
Details
- Language :
- English
- ISSN :
- 1742-2094
- Volume :
- 18
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of neuroinflammation
- Publication Type :
- Academic Journal
- Accession number :
- 34092245
- Full Text :
- https://doi.org/10.1186/s12974-021-02177-0