Immunological Biomarkers in Patients With Acute Ischemic Stroke

Clinical Implications of a Panel of Immunological Biomarkers in Patients With Acute Ischemic Stroke

Stroke is accompanied by local inflammatory response and systemic immunosuppression. Immunosuppression markers are associated with the occurrence of medical complications (infections), whereas inflammatory markers are associated with worse functional prognosis.

This prospective study tries to validate in acute stroke patients the prognostic usefulness of a panel of immune biomarkers that have previously been associated with various clinical outcomes.

The identification of beneficial and harmful immune responses in cerebral ischemia will allow the prediction of the clinical course of the patients and will be helpful in designing immunomodulatory therapeutic strategies for acute stroke.

Stroke is accompanied by local inflammatory response and systemic immunosuppression. Immunosuppression markers are associated with the occurrence of medical complications (infections), whereas inflammatory markers are associated with worse functional prognosis.

This prospective study tries to validate in acute stroke patients the prognostic usefulness of a panel of immune biomarkers that have previously been associated with various clinical outcomes. The immune biomarkers will be assessed at admission, at day 1 after admission and at day 90. The assessed immune biomarker panel includes:

• Serum cortisol levels.
• Serum interleukin (IL)-10 levels.
• Proportion of circulating B lymphocytes (CD3-CD19+ cells).
• Monocyte surface expression of TLR4, HLA-DR, CD86, and VLA-4.
• Ex - vivo production of tumor necrosis factor (TNF)-α in monocytes after stimulation with LPS.
• Proportion of each of the circulating monocyte subpopulations (CD14highCD16-, CD14highCD16+, and CD14dimCD16+).

The identification of beneficial and harmful immune responses in cerebral ischemia will allow the prediction of the clinical course of the patients and will be helpful in designing immunomodulatory therapeutic strategies for acute stroke.

Inclusion Criteria:

• ischemic stroke*

• stroke onset within 6h*

• treated with systemic or intraarterial thrombolysis*

• minimum severity in the NIHSS of 3*

• age ≥ 18

• consent by the patient or the legal representative

  • These items do not apply for healthy subjects.

Exclusion Criteria:

• intracranial hemorrhage
• signs of infection at admission
• use of antibiotics, immunosuppressors or corticosteroids in the previous 3 months
• significant disability (mRS>2) before index stroke