title: Cellular immunodepression preceding infectious complications after acute ischemic stroke in humans.
abstract: 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.
authors.affiliation: Berlin Neuroimaging Center and Department of Neurology, Charité - University Medicine Berlin, Berlin, Germany. georg.haeusler@charite.de
authors.forename: Karl Georg
authors.initials: KG
authors.lastname: Haeusler
authors.forename: Wolf U H
authors.initials: WU
authors.lastname: Schmidt
authors.forename: Fabian
authors.initials: F
authors.lastname: Föhring
authors.forename: Christian
authors.initials: C
authors.lastname: Meisel
authors.forename: Thomas
authors.initials: T
authors.lastname: Helms
authors.forename: G Jan
authors.initials: GJ
authors.lastname: Jungehulsing
authors.forename: Christian H
authors.initials: CH
authors.lastname: Nolte
authors.forename: Katrin
authors.initials: K
authors.lastname: Schmolke
authors.forename: Brigitte
authors.initials: B
authors.lastname: Wegner
authors.forename: Andreas
authors.initials: A
authors.lastname: Meisel
authors.forename: Ulrich
authors.initials: U
authors.lastname: Dirnagl
authors.forename: Arno
authors.initials: A
authors.lastname: Villringer
authors.forename: Hans-Dieter
authors.initials: HD
authors.lastname: Volk
mesh_terms: 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