WHOM is going to do all the followup research needed to make this usable? With NO strategy to update and NO leadership to see research thru to the end, NOTHING WILL OCCUR.
Immunocytes Rapid Responses Post-ischemic Stroke in Peripheral Blood in Patients With Different Ages
Haiyue Zhang1, 
Jingwei Guan1, 
Hangil Lee2, Chuanjie Wu1, Kai Dong1, 
Zongjian Liu3, 
Lili Cui1, 
Haiqing Song1, 
Yuchuan Ding2 and 
Ran Meng1,4*- 1Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
- 2Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, United States
- 3Department of Rehabilitation, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
- 4Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China
Objectives: To explore the alterations in immune cell composition in peripheral blood in patients with acute ischemic stroke (AIS) based on their age group.
Methods: Patients with imaging confirmed AIS were enrolled from April 2019 to January 2020 and were divided into three groups according to their ages: <55 years (group-A), 55–65 years (group-B), and >65 years (group-C). Blood samples were collected immediately when the patients were admitted to our ward prior to any intervention. Flow cytometry was used to analyze immune cell composition in peripheral blood.
Results: A total of 41 eligible patients were included for final analysis. Among the three groups, the proportions of CD56+ CD16dim NK cells were least to greatest in group-B, group-A, then group-C, respectively. With increasing age, there was a decrease in the proportion of CD3+ T-cells (group-A vs. group-C, P = 0.016) and CD3+CD4+ T-cells (group-C vs. group-A, P = 0.008; group-C vs. group-B P = 0.026). Meanwhile, no significant differences in proportions of monocytes and B cells were observed.
Conclusions: The compositions of immune cells in peripheral blood of AIS patients were distinct when divided by age groups. Differences in immune cell ratios may affect clinical outcomes and foreshadows possible need for customized treatment of AIS in different age groups.
Introduction
Ischemic stroke is a general term for necrosis of brain tissue caused by stenosis, occlusion, or insufficiency of arteries that supply blood to the brain (e.g., carotid and vertebral arteries). It accounts for approximately 87% of all strokes. Acute ischemic stroke (AIS) is a life-threatening disease with high morbidity and mortality worldwide (1–3). The pathophysiology of AIS involves immune cell activation, inflammation, and programmed cell death; of these, immune responses play a pivotal role given their contribution to both tissue damage and repair (1, 4, 5). More specifically, during the acute stage, ischemia-induced immune response damages the brain; in the sub-acute stage, Treg cells and macrophages protect and repair the brain (6–9).
Aging is an important factor that affects immune response, thereby influencing clinical outcomes (10, 11). Although the elderly are among the most vulnerable to AIS, the influence of aging and consequent changes to immune response in AIS has not been studied well. Theoretically, as people grow older, ischemia-induced immune response may be modified and weakened, which may result in poorer outcomes. To elucidate the impact of aging on immune response to AIS, we analyzed the alterations in immune cell composition in peripheral blood of AIS patients based on their age groups. The results of this study may become references for predicting outcomes and designing customized treatment.
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