Kassner S S, Kollmar R, Bonaterra G A, Hildebrandt W, Schwab S, Kinscherf R
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany.
Neuroscience. 2009 May 5;160(2):394-401. doi: 10.1016/j.neuroscience.2009.02.050. Epub 2009 Mar 1.
Peripheral blood mononuclear cells (PBMCs), i.e. lymphocytes, monocytes and macrophages are key players in the development of innate and adaptive immune responses. However, little is known about their properties in patients with acute stroke.
We presently characterized the early time course of PBMC subpopulations in 19 patients with acute ischemic stroke and symptom onset below 6 h compared to 19 age-matched healthy subjects. Immediately after acute ischemic stroke, as well as 1 and 3 days thereafter, PBMC subpopulations (cluster of differentiation [CD]3+, CD14+, CD19+, CD68+) were isolated by magnetic bead system and the expression of proinflammatory (CD40, tumor necrosis factor-alpha [TNFalpha]), proapoptotic (caspase-3 [CPP32], poly(ADP-ribose) polymerase [PARP]) and adhesion relevant (CD38) genes was measured by quantitative polymerase chain reaction (PCR). Furthermore, besides routine parameters, plasma levels of oxidized low-density lipoproteins (oxLDL) were studied.
In comparison to healthy subjects, patients revealed (i) twofold elevated plasma oxLDL concentrations, (ii) decreased (15%) blood cholesterol levels, and (iii) a 40% decrease in total number of lymphocytes. Furthermore, the majority of PBMC subpopulations revealed an increased expression of proinflammatory, proapoptotic or adhesion-relevant genes. Significant positive correlations were observed between expression of most of these genes in PBMCs and individual plasma oxLDL concentrations.
Elevated expression of proinflammatory, proapoptotic and adhesion genes in subsets of PBMCs after ischemic stroke may contribute to an immunodepressive syndrome, possibly due to increased plasma oxLDL levels.
外周血单个核细胞（PBMC），即淋巴细胞、单核细胞和巨噬细胞，是先天性和适应性免疫反应发展中的关键参与者。然而，对于急性中风患者其特性了解甚少。
我们目前对19例急性缺血性中风且症状发作在6小时以内的患者以及19例年龄匹配的健康受试者的PBMC亚群的早期变化过程进行了特征分析。急性缺血性中风后即刻以及之后的第1天和第3天，通过磁珠系统分离PBMC亚群（分化簇[CD]3 +、CD14 +、CD19 +、CD68 +），并通过定量聚合酶链反应（PCR）检测促炎（CD40、肿瘤坏死因子-α [TNFα]）、促凋亡（半胱天冬酶-3 [CPP32]、聚（ADP-核糖）聚合酶[PARP]）和黏附相关（CD38）基因的表达。此外，除常规参数外，还研究了氧化型低密度脂蛋白（oxLDL）的血浆水平。
与健康受试者相比，患者表现出：（i）血浆oxLDL浓度升高两倍；（ii）血液胆固醇水平降低（15%）；（iii）淋巴细胞总数减少40%。此外，大多数PBMC亚群显示促炎、促凋亡或黏附相关基因的表达增加。在PBMC中这些基因的大多数表达与个体血浆oxLDL浓度之间观察到显著正相关。
缺血性中风后PBMC亚群中促炎、促凋亡和黏附基因的表达升高可能导致免疫抑制综合征，可能是由于血浆oxLDL水平升高所致。
