Adrenal hormones and circulating leukocyte subtypes in stroke patients treated with reperfusion therapy.

Abstract

Ischemic stroke sets in motion a dialogue between the central nervous and the immune systems that includes the sympathetic/adrenal system. We investigated the course of immune cells and adrenocortical and adrenomedullary effectors in a cohort of 51 patients with acute stroke receiving reperfusion therapy (intravenous alteplase or mechanical thrombectomy) and its correlation with stroke outcomes and infarct growth. Cortisol increased rapidly and fleetingly after stroke, but 39% of patients who had larger infarctions on admission showed a positive delta cortisol at day 1. It was associated with enhanced infarct growth (p = 0.002) and poor outcome [OR (95% CI) 5.30 (1.30-21.69)], and correlated with less lymphocytes and T cells at follow up. Likewise, fewer circulating lymphocytes, T cells, and Tregs were associated with infarct growth. By contrast, metanephrines did not increase at clinical onset, and decreased over time. Higher levels of NMN correlated with more Treg and B cells. Eventually, complete reperfusion at the end of therapy headed the identification of more circulating Tregs at day 1. Then activation of cortical or medullar compartments of the adrenal gland result in specific signatures on leukocyte subpopulations. Manipulation of the adrenal gland hormone levels warrants further investigation.

• Authors: Francesc Miró-Mur, Carlos Laredo, Arturo Renú, Salvatore Rudilosso, Yashu Zhao, Sergio Amaro, Laura Llull, Xabier Urra, Anna M Planas, Ángel Chamorro
• Journal: Brain, behavior, and immunity (Brain Behav Immun) Vol. 70 Pg. 346-353 (05 2018) ISSN: 1090-2139 [Electronic] Netherlands
• PMID: 29548995 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2018. Published by Elsevier Inc.

Chemical References

• Adrenal Cortex Hormones
• Metanephrine
• Tissue Plasminogen Activator
• Hydrocortisone

Topics

• Adrenal Cortex Hormones (analysis)
• Adrenal Glands (physiology)
• Aged
• Aged, 80 and over
• Brain Ischemia (immunology, therapy)
• Female
• Humans
• Hydrocortisone (analysis, blood)
• Leukocytes
• Lymphocyte Count
• Lymphocytes
• Male
• Metanephrine (analysis, blood)
• Middle Aged
• Reperfusion (methods)
• Stroke (therapy)
• T-Lymphocytes
• T-Lymphocytes, Regulatory
• Tissue Plasminogen Activator (pharmacology)
• Treatment Outcome