[The levels of expression of toll-like receptors 2 and 4 in neutrophils are associated with the prognosis of ischaemic stroke patients].
BACKGROUND
Cerebral ischaemia triggers a very intense inflammatory response that is characterised by the infiltration of leukocytes in the brain parenchyma. The first of these cells to reach the brain are the neutrophils. Nevertheless, the role played by neutrophils and the expression of their innate immunity receptors TLR2 and TLR 4 (toll-like receptors 2 and 4) in cerebral ischaemia is still not fully understood.


OBJECTIVE
To examine the association between the levels of neutrophils and the expression of TLR2 and TLR4 in those cells and the prognosis of ischaemic stroke patients.


METHODS
The study involved a sample of 110 patients with an ischaemic stroke that had started less than 12 hours earlier. The main variables that were taken into account were the modified Rankin scale at three months (poor prognosis > 2) and the volume of the infarction (measured by means of computerised tomography between days 4 and 7). We analysed the percentage of neutrophils and the mean expression of TLR2 and TLR4 in neutrophils by means of flow cytometry on admission, at 24 h, at 72 h and at 7 days.


RESULTS
The TLR4 expression in neutrophils at 72 h (odds ratio, OR = 2.1; confidence interval of 95%, CI 95% = 1.4-3.2) and at 7 days (OR = 3.2; CI 95% = 1.7-6.1) was associated independently with the patients' prognosis and with the volume of the infarction at 72 h (B = 5.4; CI 95% = 2.9-7.8) and at 7 days (B = 7.0; CI 95% = 4.5-9.6).


CONCLUSIONS
Neutrophils are associated with the prognosis of patients with ischaemic stroke through the expression of their TLR4.
Laboratorio de Investigación en Neurociencias Clínicas, Departamento de Neurología, Hospital Clínico Universitario, Universidad de Santiago de Compostela. Santiago de Compostela, A Coruña, España.
David
D
Brea
Miguel
M
Blanco
Tomás
T
Sobrino
Pedro
P
Ramos-Cabrer
José
J
Castillo
D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D005434:Flow Cytometry; D006801:Humans; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000166:cytology / Q000378:metabolism*; D011379:Prognosis; D020521:Stroke / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D051195:Toll-Like Receptor 2 / Q000097:blood* / Q000276:immunology; D051197:Toll-Like Receptor 4 / Q000097:blood* / Q000276:immunology
D051195:Toll-Like Receptor 2; D051197:Toll-Like Receptor 4