Cellular immunodepression preceding infectious complications after acute ischemic stroke in humans.
BACKGROUND
We have recently shown that ischemic stroke causes a stress-mediator-induced long-lasting immunodepressive state in mice.


METHODS
Using head magnetic resonance imaging and standardized immunoassays, we prospectively investigated whether poststroke immunodepression is also seen in humans.


RESULTS
Compared to healthy volunteers (n = 30), a rapid depression of lymphocyte counts and a functional deactivation of monocytes and T helper type 1 cells was observed in acute stroke patients (SP; n = 40). Immunodepression was more pronounced in patients with severe clinical deficit or large infarction. On admission the combination of monocytic tumor necrosis factor alpha release ex vivo and the National Institute of Health Stroke Scale score were the best predictors for nosocomial infection, preferentially affecting older SP.


CONCLUSIONS
Our data provide evidence for an immediate suppression of cell-mediated immune responses after ischemic stroke in humans.
Haeusler
Karl Georg
KG
Berlin Neuroimaging Center and Department of Neurology, Charité - University Medicine Berlin, Berlin, Germany. georg.haeusler@charite.de
Schmidt
Wolf U H
WU
Föhring
Fabian
F
Meisel
Christian
C
Helms
Thomas
T
Jungehulsing
G Jan
GJ
Nolte
Christian H
CH
Schmolke
Katrin
K
Wegner
Brigitte
B
Meisel
Andreas
A
Dirnagl
Ulrich
U
Villringer
Arno
A
Volk
Hans-Dieter
HD
D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications / Q000276:immunology* / Q000473:pathology; D016022:Case-Control Studies; D015331:Cohort Studies; D003428:Cross Infection / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007108:Immune Tolerance / Q000502:physiology*; D007111:Immunity, Cellular / Q000502:physiology*; D015994:Incidence; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000276:immunology* / Q000473:pathology