Document Detail

Immunodepression after aneurysmal subarachnoid hemorrhage.
MedLine Citation:
PMID:  21088239     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: immunodepression after stroke is associated with complications like high infection rate, but its role in aneurysmal subarachnoid hemorrhage (aSAH) is unclear. This pilot study aimed to assess the presence of immunodepression and its association with infections after aSAH.
METHODS: sixteen aSAH patients were enrolled in a prospective study on immune function in a single institution. Detailed immune monitoring (peripheral blood leukocyte subsets, monocyte human leukocyte antigen-DR expression, ex vivo lipopolysaccharide-induced monocytic, Concanavalin A-induced lymphocytic cytokine secretion) was performed until day 10 after aSAH. Occurrence of infection was assessed within 14 days after aSAH.
RESULTS: sixteen consecutive aSAH patients (53.1 ± 10.2 years; mean ± SD) met the inclusion criteria, classified as asymptomatic (World Federation of Neurological Surgeons; median, 1; quartile, 1-1; n=7) and symptomatic (median, 4; quartile, 3-5; n=9), all presenting with acute neurological deficits, and 5 of these had additional delayed cerebral ischemia. T-lymphopenia, impaired ex vivo lymphocytic/monocytic cytokine secretion, and decreased monocyte human leukocyte antigen-DR expression occurred over all World Federation of Neurological Surgeons grades but persisted beyond day 3 only in symptomatic patients. Pneumonia (67%; P=0.011) was more frequent in symptomatic patients. Already at day 1, patients with pneumonia showed significantly lower T-cell counts and mitogen-induced interferon-γ production compared to patients without infections.
CONCLUSIONS: a pronounced SAH-induced immunodepression was observed early after aSAH but persisted only in symptomatic patients. Immunodepression was associated with a high incidence of pneumonia. Early diagnosis of immunodepression might allow targeted treatment to prevent infectious complications after aSAH.
Asita Sarrafzadeh; Florian Schlenk; Andreas Meisel; Jens Dreier; Peter Vajkoczy; Christian Meisel
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Publication Detail:
Type:  Journal Article     Date:  2010-11-18
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  42     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-28     Completed Date:  2011-01-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  53-8     Citation Subset:  IM    
Department of Neurosurgery, Charité Campus Virchow Medical Center, Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
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MeSH Terms
Cells, Cultured
Concanavalin A / pharmacology
Gene Expression Regulation / drug effects,  immunology
HLA-DR Antigens / biosynthesis,  immunology
Immune Tolerance*
Infection / etiology,  immunology,  metabolism
Interferon-gamma / immunology,  secretion
Lipopolysaccharides / pharmacology
Lymphocytes / immunology,  secretion
Middle Aged
Mitogens / pharmacology
Monocytes / immunology,  secretion
Pneumonia / etiology,  immunology,  metabolism
Prospective Studies
Subarachnoid Hemorrhage / complications*,  immunology*,  metabolism
Time Factors
Reg. No./Substance:
0/HLA-DR Antigens; 0/Lipopolysaccharides; 0/Mitogens; 11028-71-0/Concanavalin A; 82115-62-6/Interferon-gamma

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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