Stroke-induced immunodepression: Experimental evidence and clinical relevance

Ulrich Dirnagl, Juliane Klehmet, Johann S. Braun, Hendrik Harms, Christian Meisel, Tjalf Ziemssen, Konstantin Prass, Andreas Meisel

Research output: Contribution to journalArticlepeer-review

366 Citations (Scopus)

Abstract

Stroke affects the normally well-balanced interplay of the 2 supersystems: the nervous and the immune system. Recent research elucidated some of the involved signals and mechanisms and, importantly, was able to demonstrate that brain-immune interactions are highly relevant for functional outcome after stroke. Immunodepression after stroke increases the susceptibility to infection, the most relevant complication in stroke patients. However, immunodepression after stroke may also have beneficial effects, for example, by suppressing autoaggressive responses during lesion-induced exposure of central nervous system-specific antigens to the immune system. Thus, before immunomodulatory therapy can be applied to stroke patients, we need to understand better the interaction of brain and immune system after focal cerebral ischemia. Until then, anticipating an important consequence of stroke-induced immunodepression, bacterial infection, preventive antibiotic strategies have been proposed. In mouse experiments, preventive antibiotic treatment dramatically improves mortality and outcome. Results of clinical studies on this issue are contradictory at present, and larger trials are needed to settle the question whether (and which) stroke patients should be preventively treated. Nevertheless, clinical evidence is emerging demonstrating that stroke-induced immunodepression in humans not only exists, but has very similar features to those characterized in rodent experiments.

Original languageEnglish
Pages (from-to)770-773
Number of pages4
JournalStroke
Volume38
Issue number2 PART 2
DOIs
Publication statusPublished - Feb 2007

Keywords

  • Brain infarction
  • Brain ischemia
  • Experimental
  • Focal ischemia
  • Immunology
  • Infectious disease
  • Inflammation
  • Treatment

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialised Nursing

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