title: Increased Th17/Treg Ratio in Poststroke Fatigue.
abstract: Fatigue is a major debilitating symptom after stroke. The biological mechanisms underlying poststroke fatigue (PFS) are unknown. We hypothesized that PSF is associated with an alteration in the balance between Th17 and Treg cells. To test this hypothesis we assessed fatigue in 30 stroke survivors using the Fatigue Scale for Motor and Cognitive Functions (FSMC). Peripheral blood was collected for assessment of Th17 and Treg cell populations and measurement of interleukin-10 (IL-10). Participants were dichotomized into severe fatigue (n = 14) and low-moderate fatigue (n = 16) groups by K-mean cluster analysis of FSMC scores. There were no group differences in age, gender, stroke type, stroke severity, or time since stroke. Stroke survivors in the severe fatigue group reported greater anxiety (p = 0.004) and depression (p = 0.001) than in the low-moderate fatigue group. The ratio of Th17 to Treg cells was significantly increased in the severe fatigue group relative to the mild-moderate fatigue group (p = 0.035). Serum levels of IL-10 negatively correlated withTh17/Treg ratio (r = -0.408,  p = 0.025). Our preliminary findings suggest that an imbalance in the Th17/Treg ratio is associated with the severity of PSF.
authors.affiliation: Neurology Department, The First Affiliated Hospital of Zhengzhou University, 1 East Jianshe Road, Zhengzhou, Henan 450052, China.
authors.forename: Xinjing
authors.initials: X
authors.lastname: Liu
authors.affiliation: School of Nursing, Fatigue Research Laboratory, MGH Institute of Health Professions, 36 1st Avenue, Charlestown, MA 02129, USA.
authors.forename: Komal
authors.initials: K
authors.lastname: Kenkare
authors.affiliation: Basic Medical College, Guangdong Pharmaceutical University, Guangzhou 510006, China.
authors.forename: Shanshan
authors.initials: S
authors.lastname: Li
authors.affiliation: Spaulding Rehabilitation Hospital, 300 First Avenue, Charlestown, MA 02129, USA.
authors.forename: Varsha
authors.initials: V
authors.lastname: Desai
authors.affiliation: School of Nursing, Fatigue Research Laboratory, MGH Institute of Health Professions, 96 13th Street, Charlestown, MA 02129, USA.
authors.forename: John
authors.initials: J
authors.lastname: Wong
authors.affiliation: Department of Rehabilitation Medicine, Fourth Affiliated Hospital of Zhengzhou University, 169-10 Nanyang Road, Zhengzhou, Henan 450044, China.
authors.forename: Xun
authors.initials: X
authors.lastname: Luo
authors.affiliation: School of Nursing, Fatigue Research Laboratory, MGH Institute of Health Professions, 96 13th Street, Charlestown, MA 02129, USA.
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Wood
authors.affiliation: Neurology Department, The First Affiliated Hospital of Zhengzhou University, 1 East Jianshe Road, Zhengzhou, Henan 450052, China.
authors.forename: Yuming
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, Harvard Medical School, 96 13th Street, Charlestown, MA 02129, USA.
authors.forename: Qing Mei
authors.initials: QM
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology; D003863:Depression / Q000209:etiology; D005221:Fatigue / Q000209:etiology / Q000276:immunology*; D005260:Female; D006801:Humans; D016753:Interleukin-10 / Q000097:blood; D008297:Male; D008875:Middle Aged; D012893:Sleep Wake Disorders / Q000209:etiology; D020521:Stroke / Q000150:complications / Q000276:immunology*; D050378:T-Lymphocytes, Regulatory / Q000276:immunology*; D058504:Th17 Cells / Q000276:immunology*
chemical_list: D016753:Interleukin-10