RT Journal Article
T1 Stroke-induced immunosuppression: implications for the prevention and prediction of post-stroke infections
A1 Faura, Júlia
A1 Bustamante, Alejandro
A1 Miró-Mur, Francesc
A1 Montaner, Joan
K1 Stroke
K1 Immunosuppression
K1 Biomarkers
K1 Inflammation
K1 Infection
K1 Pneumonia
K1 Accidente cerebrovascular
K1 Terapia de inmunosupresión
K1 Biomarcadores
K1 Inflamación
K1 Infecciones
K1 Neumonía
AB 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.
PB BioMed Central Ltd.
YR 2021
FD 2021-06-06
LK http://hdl.handle.net/10668/3982
UL http://hdl.handle.net/10668/3982
LA en
NO Faura J, Bustamante A, Miró-Mur F, Montaner J. Stroke-induced immunosuppression: implications for the prevention and prediction of post-stroke infections. J Neuroinflammation. 2021 Jun 6;18(1):127
DS RISalud
RD Apr 7, 2025