Brea David, Blanco Miguel, Sobrino Tomás, Ramos-Cabrer Pedro, Castillo José
Laboratorio de Investigación en Neurociencias Clínicas, Departamento de Neurología, Hospital Clínico Universitario, Universidad de Santiago de Compostela. Santiago de Compostela, A Coruña, España.
Rev Neurol. 2011 Jan 1;52(1):12-9.
Cerebral ischaemia triggers a very intense inflammatory response that is characterised by the infiltration of leukocytes in the brain parenchyma. The first of these cells to reach the brain are the neutrophils. Nevertheless, the role played by neutrophils and the expression of their innate immunity receptors TLR2 and TLR 4 (toll-like receptors 2 and 4) in cerebral ischaemia is still not fully understood.
To examine the association between the levels of neutrophils and the expression of TLR2 and TLR4 in those cells and the prognosis of ischaemic stroke patients.
The study involved a sample of 110 patients with an ischaemic stroke that had started less than 12 hours earlier. The main variables that were taken into account were the modified Rankin scale at three months (poor prognosis > 2) and the volume of the infarction (measured by means of computerised tomography between days 4 and 7). We analysed the percentage of neutrophils and the mean expression of TLR2 and TLR4 in neutrophils by means of flow cytometry on admission, at 24 h, at 72 h and at 7 days.
The TLR4 expression in neutrophils at 72 h (odds ratio, OR = 2.1; confidence interval of 95%, CI 95% = 1.4-3.2) and at 7 days (OR = 3.2; CI 95% = 1.7-6.1) was associated independently with the patients' prognosis and with the volume of the infarction at 72 h (B = 5.4; CI 95% = 2.9-7.8) and at 7 days (B = 7.0; CI 95% = 4.5-9.6).
Neutrophils are associated with the prognosis of patients with ischaemic stroke through the expression of their TLR4.
脑缺血引发非常强烈的炎症反应，其特征是白细胞浸润脑实质。最早到达脑部的这些细胞是中性粒细胞。然而，中性粒细胞所起的作用及其固有免疫受体TLR2和TLR4（Toll样受体2和4）在脑缺血中的表达仍未完全明确。
研究中性粒细胞水平及其细胞中TLR2和TLR4的表达与缺血性中风患者预后之间的关联。
该研究纳入了110例发病时间少于12小时的缺血性中风患者样本。主要考虑的变量为三个月时的改良Rankin量表评分（预后不良>2）以及梗死体积（在第4至7天通过计算机断层扫描测量）。我们通过流式细胞术分析了入院时、24小时、72小时和7天时中性粒细胞的百分比以及中性粒细胞中TLR2和TLR4的平均表达。
中性粒细胞中TLR4在72小时（比值比，OR = 2.1；95%置信区间，CI 95% = 1.4 - 3.2）和7天时（OR = 3.2；CI 95% = 1.7 - 6.1）的表达与患者预后以及72小时（B = 5.4；CI 95% = 2.9 - 7.8）和7天时（B = 7.0；CI 95% = 4.5 - 9.6）的梗死体积独立相关。
中性粒细胞通过其TLR4的表达与缺血性中风患者的预后相关。
