Journal ArticleDOI
The immunology of acute stroke.
Ángel Chamorro,Andreas Meisel,Anna M. Planas,Xabier Urra,Diederik van de Beek,Roland Veltkamp +5 more
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TLDR
The multifaceted role of the immune system in the pathophysiology of acute stroke is discussed, with increased incidence of infections observed after acute stroke, and might result from activation of long-distance feedback loops between the CNS and peripheral immune organs.Abstract:
Recent clinical and experimental studies have highlighted a complex role for the immune system in the pathophysiological changes that occur after acute stroke. Sensors of the innate immune system such as Toll-like receptors, or effectors such as the lectin pathway of complement activation and innate immune cells, are activated by brain ischaemia and tissue damage, leading to amplification of the inflammatory cascade. Activation of the adaptive arm of the immune system, mediated by lymphocyte populations including T and B cells, regulatory T cells, and γδT cells, in response to stroke can lead to deleterious antigen-specific autoreactive responses but can also have cytoprotective effects. Increased incidence of infections is observed after acute stroke, and might result from activation of long-distance feedback loops between the CNS and peripheral immune organs, which are thought to play a part in stroke-induced immunodepression. Ongoing clinical trials are investigating whether the preventive use of antibiotics improves functional outcome after stroke. This Review discusses the multifaceted role of the immune system in the pathophysiology of acute stroke.read more
Citations
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Neuroprotection in acute stroke: targeting excitotoxicity, oxidative and nitrosative stress, and inflammation
TL;DR: In this paper, the authors used pre-clinical testing and appropriate selection of study participants to overcome the barriers to progress in acute ischemic stroke research, and proposed safe and effective treatment strategies that combine neuroprotection reperfusion, better use of advanced brain imaging for patient selection, and wider implementation of pre-hospital conducted clinical trials.
Journal ArticleDOI
Stroke-Associated Pneumonia: Major Advances and Obstacles
TL;DR: The pathophysiology of SAP is likely explained by aspiration combined with stroke-induced immunodepression through complex humeral and neural pathways that include the hypothalamic-pituitary-adrenal axis, parasympathetic and sympathetic systems.
Journal ArticleDOI
Inflammation in neurodegenerative diseases – an update
Sandra Amor,Sandra Amor,Laura A. N. Peferoen,Daphne Y.S. Vogel,Marjolein Breur,Paul van der Valk,David Baker,Johannes M. van Noort +7 more
TL;DR: A better understanding of how immune responses are involved in neuronal damage and regeneration will be essential to develop effective therapies to improve quality of life, and mitigate the personal, economic and social impact of neurodegenerative disorders.
Journal ArticleDOI
The role of peripheral immune cells in the CNS in steady state and disease
Marco Prinz,Josef Priller +1 more
TL;DR: Strategies for targeting peripheral immune cells to reduce CNS disease burden are assessed on the basis of observations of myeloid cells in the CNS parenchyma and at CNS–periphery interfaces.
Journal ArticleDOI
Pathogenic mechanisms following ischemic stroke
TL;DR: The underlying pathophysiology of ischemic stroke is reviewed and the intertwined pathways that are promising therapeutic targets are revealed, leading to the development of numerous agents that target various injury pathways.
References
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Central nervous system injuryinduced immune deficiency syndrome
TL;DR: Understanding CIDS will allow us to work on developing effective therapeutic strategies, with which the outcome after CNS damage by a host of diseases could be improved by eliminating a major determinant of poor recovery.
Journal ArticleDOI
Urinary tract infection and bacteriurua in stroke patients: frequencies, pathogen microorganisms, and risk factors.
TL;DR: Early treatment of urinary dysfunction for elimination of indwelling catheter use and high postvoid residue, early physical rehabilitation for better ambulation and hand function, patient education about prevention, and close monitoring of patients with unmodifiable risk factors may decrease the frequency of urinary tract infections and significant bacteriuria in stroke patients.
Journal ArticleDOI
The impact of lesion location and lesion size on poststroke infection frequency
Jens Minnerup,Heike Wersching,Benjamin Brokinkel,Rainer Dziewas,Peter U. Heuschmann,D. G. Nabavi,Erich Bernd Ringelstein,Wolf-Rüdiger Schäbitz,Martin A. Ritter +8 more
TL;DR: Lesion size is an independent risk factor for the development of poststroke infection, and the left anterior cerebral artery territory was associated with pneumonia.
Journal ArticleDOI
Preventive antibiotics in stroke study: rationale and protocol for a randomised trial.
Paul J. Nederkoorn,Willeke F. Westendorp,Imke J. Hooijenga,Rob J. de Haan,Diederik W.J. Dippel,Frederique H Vermeij,Marcel G. W. Dijkgraaf,Jan M. Prins,Lodewijk Spanjaard,Diederik van de Beek +9 more
TL;DR: Whether the preventive use of the antibiotic ceftriaxone improves functional outcome in patients with stroke is investigated to determine whether the effect of antibiotic prophylaxis on clinical outcomes is improved.
Journal ArticleDOI
Sensitization and Tolerization to Brain Antigens in Stroke
TL;DR: Data suggest that the immune response can be manipulated in an antigen specific fashion to improve stroke outcome and argue that the nature of the post-ischemic immune response influences neurological recovery from stroke.